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VA &lt; 3/60", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>NPCB Classification of Visual Impairment</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>The National Programme for Control of <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">Blindness</span> (NPCB) in India defines <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> as \"visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of &lt;3/60 in a better eye with best possible correction\" and central <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> &lt;10 degrees. The NPCB further categorizes visual <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> as:</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Visual Acuity</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Visual Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 6/18 in the better eye with available correction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Low Vision</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 6/18 to 6/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Economic Blindness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 6/60 to 3/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Social Blindness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 3/60 to 1/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Manifest Blindness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 1/60 to the perception of light</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Absolute Blindness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>No perception of light</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>WHO Classification of Visual Impairment</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>The World Health Organization (WHO) defines <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> as \"visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 3/60 (Snellen) or its equivalent\".<strong>(Option A)</strong></p>\n<p>The International Classification of Disease 11 (2018) classifies vision <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> into distance and near-presenting vision impairment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Visual Acuity</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Mild Distance Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 6/12</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Moderate Distance Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 6/18</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Severe Distance Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 6/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Blindness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 3/60<strong> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Near Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Presenting near vision <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than N6 or M0.8 at 40 cm with existing correction</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "According to the National Blindness and Visual Impairment Survey conducted from 2015 to 2019, what is the leading cause of moderate to severe visual impairment?", "options": [{"label": "A", "text": "Refractive error", "correct": false}, {"label": "B", "text": "Untreated cataract", "correct": true}, {"label": "C", "text": "Glaucoma", "correct": false}, {"label": "D", "text": "Diabetic retinopathy", "correct": false}], "correct_answer": "B. Untreated cataract", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is the most common cause of preventable childhood blindness in India?", "options": [{"label": "A", "text": "Refractive error", "correct": false}, {"label": "B", "text": "Vitamin A deficiency", "correct": true}, {"label": "C", "text": "Retinopathy of prematurity", "correct": false}, {"label": "D", "text": "Cataract", "correct": false}], "correct_answer": "B. Vitamin A deficiency", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/xOrzIxMAZgskbRi5SqzM1747911070.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:630px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:1px solid #333438\">\n<p><strong>Tier</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:1px solid #333438\">\n<p><strong>Number of Units</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:1px solid #333438\">\n<p><strong>Population Norms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:1px solid #333438\">\n<p><strong>Components</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Centres of Excellence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>20</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>1/50 million</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<ul>\n<li>Professional Leadership</li>\n<li>Strategy development</li>\n<li>Continued Medical Education (CME)</li>\n<li>Laying of standards and quality assurance</li>\n<li>Research</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Training Centres </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>200</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>1/5 million</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<ul>\n<li>Tertiary eye care including <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> surgery, corneal transplantation, <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> surgery, etc.</li>\n<li>Training and CME</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Service Centres</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>2000</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>1/500000</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<ul>\n<li>Cataract Surgery</li>\n<li>Other common eye surgeries</li>\n<li>Facilities for refraction</li>\n<li>Referral services</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #333438; border-left:1px solid #333438; border-right:1px solid #333438; border-top:none\">\n<p><strong>Vision Centres </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>20,000</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<p>1/50000</p>\n</td>\n<td style=\"border-bottom:1px solid #333438; border-left:none; border-right:1px solid #333438; border-top:none\">\n<ul>\n<li>Refraction and prescription of glasses</li>\n<li>Primary eye care</li>\n<li>School eye screening programme</li>\n<li>Screening and referral services</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What type of visual impairment does a person have if their vision is less than 3/60 but greater than 1/60 in their better eye, and their field of vision is limited to less than 10 degrees from the center of fixation?", "options": [{"label": "A", "text": "Curable blindness", "correct": false}, {"label": "B", "text": "Economic blindness", "correct": false}, {"label": "C", "text": "Social blindness", "correct": true}, {"label": "D", "text": "Manifest blindness", "correct": false}], "correct_answer": "C. Social blindness", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>NPCB <span class=\"customMeta\" data-dictid=\"dda6ab11271692777184264b752d39\">Classification</span> of Visual Impairment</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p>The National Programme for Control of <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">Blindness</span> (NPCB) in India defines <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> as \"<strong>visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of &lt;3/60 in a better eye with best possible correction</strong>\" and <strong>central <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> &lt;10 degrees</strong>. The NPCB further categorizes visual <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> as:</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p><strong>Visual Acuity</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Visual Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 6/18 in the better eye with available correction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Low Vision</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 6/18 to 6/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Economic <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">Blindness</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 6/60 to 3/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Social <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">Blindness</span> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 3/60 to 1/60</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Manifest <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">Blindness</span> (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 1/60 to the perception of light</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Absolute Blindness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>No perception of light</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:588px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>WHO <span class=\"customMeta\" data-dictid=\"dda6ab11271692777184264b752d39\">Classification</span> of Visual Impairment</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p>The <span class=\"customMeta\" data-dictid=\"755191f69b1692777202502ef70aaf\">World Health Organization</span> (WHO) defines <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> as \"<strong>visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> of less than 3/60 (Snellen) or its equivalent</strong>\".</p>\n<p>The International <span class=\"customMeta\" data-dictid=\"dda6ab11271692777184264b752d39\">Classification</span> of Disease 11 (2018) classifies vision <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> into distance and near-presenting vision impairment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p><strong>Visual Acuity</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Mild Distance Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 6/12</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Moderate Distance Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 6/18</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Severe Distance Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 6/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Blindness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Presenting visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than 3/60</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Near Vision Impairment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Presenting near vision <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> worse than N6 or M0.8 at 40 cm with existing correction</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which organism is most likely causing the infection in a 14-day-old neonate with bilateral conjunctivitis and lung infiltrates, as found in a chest X-ray performed at the outpatient department?", "options": [{"label": "A", "text": "Streptococcus", "correct": false}, {"label": "B", "text": "Hemophilus influenzae", "correct": false}, {"label": "C", "text": "Chlamydia trachomatis", "correct": true}, {"label": "D", "text": "Mycoplasma", "correct": false}], "correct_answer": "C. Chlamydia trachomatis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:664px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Ophthalmia neonatorum </strong>or <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> is a mucoid, mucopurulent, or <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> from one or both eyes in the <strong>first month of life.</strong></li>\n<li>Any discharge, even watery, from a baby’s eyes in the first week of life must be viewed under suspicion as <span class=\"customMeta\" data-dictid=\"1717bdb5d21692777200d45e31ceed\">tears</span> are not secreted so early in life.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Aetiology of <span class=\"customMeta\" data-dictid=\"90a2d671aa1692777194671fabce36\">ophthalmia</span> neonatorum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mode of infection:</strong></p>\n<ul>\n<li><strong>Before birth:</strong>\n<ul>\n<li>Very rare through infected <span class=\"customMeta\" data-dictid=\"a056bdaab516927771910777a23a21\">liquor</span> amnii</li>\n</ul>\n</li>\n<li><strong>During birth:</strong>\n<ul>\n<li>From an infected birth canal</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>After birth:</strong>\n<ul>\n<li>During the first bath of a newborn</li>\n<li>Soiled clothes</li>\n<li>Fingers with infected lochia</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Source of infection:</strong></p>\n<ul>\n<li><strong>Neisseria gonorrhoeae:</strong><strong> </strong><strong> </strong>\n<ul>\n<li>Transmitted at the<strong> time of delivery</strong></li>\n<li>Presents between <strong>2-5 days</strong> of birth <strong>(Option B)</strong></li>\n<li>The <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> becomes <span class=\"customMeta\" data-dictid=\"66d0cfdc741692777193d2b4fe3249\">mucopurulent</span> and <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> quickly</li>\n<li>Thick yellow <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">pus</span> and marked chemosis</li>\n<li>Cornea seen at the bottom of a crater-like pit in severe cases</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Chlamydia trachomatis: </strong>\n<ul>\n<li>Transmitted at the<strong> time of delivery</strong></li>\n<li>Onset at <strong> 5-14 days</strong> after birth <strong>(Option C)</strong></li>\n<li>Serotypes D to K are the most common cause of <span class=\"customMeta\" data-dictid=\"90a2d671aa1692777194671fabce36\">ophthalmia</span> neonatorum in developed countries</li>\n<li>Characteristic <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> <span class=\"customMeta\" data-dictid=\"c3b8b9a17416927771906b1bebb13c\">inclusion</span> bodies are seen</li>\n<li>Less severe inflammation</li>\n<li>Purulent <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> +</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Other causes:</strong>\n<ul>\n<li>Staphylococci/ <span class=\"customMeta\" data-dictid=\"9562e26acc16927771995a2028dd05\">Streptococcus</span> pneumoniae <strong> </strong><strong>(Option A)</strong></li>\n<li>Gram-negative coliforms</li>\n<li>Herpes simplex virus</li>\n<li>Chemical: silver <span class=\"customMeta\" data-dictid=\"ad09a76257169277719349e2735418\">nitrate</span> solution previously used for <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> immediately after birth<strong>:</strong><strong> </strong>erythema, chemosis, lid edema, and <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> within the first<strong> 24 hours </strong>after birth.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Prophylaxis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Antenatal measures:</strong>\n<ul>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"0e919a208b16927771885d9c1f6662\">genital</span> infections and care of mother</li>\n<li>Surveillance of pregnant women for STDs</li>\n</ul>\n</li>\n<li><strong>Natal measures:</strong>\n<ul>\n<li>Aseptic, <span class=\"customMeta\" data-dictid=\"fc3d080799169277719904701c07f9\">sterile</span> precautions to be followed during deliveries</li>\n<li>Clean the infant’s closed lids with <span class=\"customMeta\" data-dictid=\"fc3d080799169277719904701c07f9\">sterile</span> cotton soaked in <span class=\"customMeta\" data-dictid=\"ab6984f43316927771937ff19f3807\">normal saline</span> and dried</li>\n</ul>\n</li>\n<li><strong>Post-natal measures:</strong>\n<ul>\n<li>Povidone-iodine 2.5% solution</li>\n<li>If the mother is under suspicion, <strong>1% tetracycline</strong> or <strong>0.5% erythromycin</strong> eye <span class=\"customMeta\" data-dictid=\"25ee86538e1692777194ef5ba9e4f1\">ointment</span> is used in the baby immediately after birth and watched for a week.</li>\n<li><strong>Ceftriaxone 50mg/kg IM or IV single dose</strong> for infants born to mothers with untreated gonococcal infection.</li>\n</ul>\n</li>\n<li><strong>Crede’s method:</strong>\n<ul>\n<li>Old method using 1% silver <span class=\"customMeta\" data-dictid=\"ad09a76257169277719349e2735418\">nitrate</span> applied to infants' eyes right after birth</li>\n<li>It is <strong>NOT used now</strong> as it can cause chemical <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> conjunctivitis.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neisseria gonorrhoea </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ceftriaxone IM, <span class=\"customMeta\" data-dictid=\"ca244a562f16927771884ac81c7d2e\">gentamicin</span> drops, <span class=\"customMeta\" data-dictid=\"32ff1dc5e01692777182a5338b6367\">bacitracin</span> eye ointment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chemical </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Wash eyes, <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> ointment, observe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other bacteria </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neomycin-bacitracin ointment, gentamicin, or <span class=\"customMeta\" data-dictid=\"23e84a422c1692777200166ff709ff\">tobramycin</span> drops</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Herpes simplex virus </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acyclovir 3% eye ointment, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"060850cb871692777180ce7d18e840\">acyclovir</span> (systemic involvement)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chlamydia trachomatis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erythromycin or <span class=\"customMeta\" data-dictid=\"840aca53001692777184ed7e6cddf9\">chlortetracycline</span> eye ointment, oral <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> (systemic infection)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not included in the SAFE strategy for trachoma?", "options": [{"label": "A", "text": "Antibiotics", "correct": false}, {"label": "B", "text": "Surgery for trichiasis", "correct": false}, {"label": "C", "text": "Evaluation of control program", "correct": true}, {"label": "D", "text": "Facial cleanliness", "correct": false}], "correct_answer": "C. Evaluation of control program", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:651px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Investigations </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Micro-immunofluorescence (micro-IF): Using pooled antigens; For routine <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> purposes</li>\n<li>Culture of C. trachomatis: In irradiated McCoy cells; Expensive</li>\n<li>Monoclonal <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> direct tests: IgA-IPA light <span class=\"customMeta\" data-dictid=\"51df8cdfc91692777192aa76f4de51\">microscopy</span> tests are the best combination for diagnosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management (SAFE strategy)</strong></p>\n<p> </p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>SAFE</strong> is a WHO-recommended combination of interventions to treat <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">trachoma</span> and prevent it from leading to blindness</p>\n<ul>\n<li><strong>S</strong>urgery for <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">cicatricial</span> <span class=\"customMeta\" data-dictid=\"bcd6d163731692777187fccac22750\">entropion</span> and <span class=\"customMeta\" data-dictid=\"707ba8ae1b1692777200f19bfbcdba\">trichiasis</span> (Tertiary prevention)</li>\n<li><strong>A</strong>ntibiotics to eliminate the organism (Secondary prevention)</li>\n<li><strong>F</strong>acial cleanliness to avoid infection (Primary prevention)</li>\n</ul>\n<ul>\n<li><strong>E</strong>nvironmental improvement with better <span class=\"customMeta\" data-dictid=\"15fa752a4f1692777189fe275abf3f\">hygiene</span> and <span class=\"customMeta\" data-dictid=\"18aafee1a71692777198cdc688e8aa\">sanitation</span> (Primordial prevention)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Surgery (Tertiary prevention) (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Epilation/ Bilamellar <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> rotation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Antibiotics (Secondary prevention) (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>For areas with 10% or more <span class=\"customMeta\" data-dictid=\"f86aae0bd61692777196f91458c9dd\">prevalence</span> of active <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">trachoma</span> (TF in children 1-9 yrs): <span class=\"customMeta\" data-dictid=\"765229d44a1692777182fb0343abf4\">Azithromycin</span> single oral dose 20 mg/kg</strong> to all community members</li>\n<li><strong>5% to 10% prevalence: </strong>Antibiotic therapy targeted in the family and close contact only</li>\n<li><strong>Less than 5% prevalence:</strong> Only patients are treated</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Facial cleanliness (Primary prevention) (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Frequent face wash with clean water, Avoid common towels, handkerchiefs, <span class=\"customMeta\" data-dictid=\"1f30aa8f821692777199c5995b237b\">Surma</span> rods, etc</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Environmental improvement (Primordial prevention) (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Water latrines and good water supply to reduce flies, Sprays to control flies, Health education</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Vision 20/20- Which was added recently in India?", "options": [{"label": "A", "text": "Cataract", "correct": false}, {"label": "B", "text": "Childhood blindness", "correct": false}, {"label": "C", "text": "Glaucoma", "correct": false}, {"label": "D", "text": "Refractive error and low vision", "correct": true}], "correct_answer": "D. Refractive error and low vision", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A person comes with the visual acuity in the right eye of 6/60 and left eye of 3/60. He should be categorized into which type of blindness?", "options": [{"label": "A", "text": "Mild", "correct": false}, {"label": "B", "text": "Moderate", "correct": false}, {"label": "C", "text": "Severe", "correct": true}, {"label": "D", "text": "No blindness", "correct": false}], "correct_answer": "C. Severe", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Severe:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>WHO’s <span class=\"customMeta\" data-dictid=\"dda6ab11271692777184264b752d39\">Classification</span> of Visual <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">Impairment</span> based on severity</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CATEGORY OF VI</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CORRECTED VA (BETTER Eye)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>DEGREE OF VI</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6/6 – 6/18</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less than 6/18 – 6/60</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate Visual Impairment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less than 6/60 – 3/60</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe Visual Impairment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less than 3/60 – 1/60</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blind</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less than 1/60 – PL</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blind</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>NPL</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blind</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Most common cause of blindness in India is?", "options": [{"label": "A", "text": "Cataract", "correct": true}, {"label": "B", "text": "Refractive error", "correct": false}, {"label": "C", "text": "Trachoma", "correct": false}, {"label": "D", "text": "Glaucoma", "correct": false}], "correct_answer": "A. Cataract", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 19 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - 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The discharge was initially serous, but it quickly turned into mucopurulent and then purulent. On examination, the eyes are bright red and swollen. What is the most likely causative agent here?", "options": [{"label": "A", "text": "Chlamydia trachomatis", "correct": false}, {"label": "B", "text": "Silver nitrate", "correct": false}, {"label": "C", "text": "Treponema pallidum", "correct": false}, {"label": "D", "text": "Neisseria gonorrhoeae", "correct": true}], "correct_answer": "D. Neisseria gonorrhoeae", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/d1patYQteDCJhTtZAznQ1747215324.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:664px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Ophthalmia neonatorum </strong>or <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> is a mucoid, mucopurulent, or <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> from one or both eyes in the <strong>first month of life.</strong></li>\n<li>Any discharge, even watery, from a baby’s eyes in the first week of life must be viewed under suspicion as <span class=\"customMeta\" data-dictid=\"1717bdb5d21692777200d45e31ceed\">tears</span> are not secreted so early in life.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Aetiology of <span class=\"customMeta\" data-dictid=\"90a2d671aa1692777194671fabce36\">ophthalmia</span> neonatorum</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mode of infection:</strong></p>\n<ul>\n<li><strong>Before birth:</strong>\n<ul>\n<li>Very rare through infected <span class=\"customMeta\" data-dictid=\"a056bdaab516927771910777a23a21\">liquor</span> amnii</li>\n</ul>\n</li>\n<li><strong>During birth:</strong>\n<ul>\n<li>From an infected birth canal</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>After birth:</strong>\n<ul>\n<li>During the first bath of a newborn</li>\n<li>Soiled clothes</li>\n<li>Fingers with infected lochia</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Source of infection:</strong></p>\n<ul>\n<li><strong>Neisseria gonorrhoeae:</strong>\n<ul>\n<li>Transmitted at the<strong> time of delivery</strong></li>\n<li>Presents between <strong>2-5 days</strong> of birth</li>\n<li>The <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> becomes <span class=\"customMeta\" data-dictid=\"66d0cfdc741692777193d2b4fe3249\">mucopurulent</span> and <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> quickly</li>\n<li>Inflamed, bright red, swollen conjunctiva</li>\n<li>Thick yellow <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">pus</span> and marked chemosis</li>\n<li>Cornea seen at the bottom of a crater-like pit in severe cases</li>\n<li>Bulbar <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> &amp; lids: dense infiltration, swollen and tense</li>\n<li>Free flow of pus, serum, and often blood later</li>\n</ul>\n</li>\n<li><strong>Chlamydia trachomatis: </strong><strong>(Option A)</strong>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"OP376-Trachomatous-inflammation-follicular\" data-author=\"John DC Anderson\" data-hash=\"12695\" data-license=\"CC BY NC 4.0\" data-source=\"https://www.cehjournal.org/resources/trachoma-teaching-set-full-text/\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/d1patYQteDCJhTtZAznQ1747215324.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</li>\n<li>Transmitted at the<strong> time of delivery</strong></li>\n<li>Onset at <strong> 5-14 days</strong> after birth</li>\n<li>Serotypes D to K are the most common cause of <span class=\"customMeta\" data-dictid=\"90a2d671aa1692777194671fabce36\">ophthalmia</span> neonatorum in developed countries</li>\n<li>Characteristic <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> <span class=\"customMeta\" data-dictid=\"c3b8b9a17416927771906b1bebb13c\">inclusion</span> bodies are seen</li>\n<li>Less severe inflammation</li>\n<li>Purulent discharge</li>\n<li><strong>Other causes:</strong>\n<ul>\n<li>Staphylococci</li>\n<li>Streptococcus pneumoniae</li>\n<li>Gram-negative coliforms</li>\n<li>Herpes simplex virus</li>\n<li>Chemical: silver <span class=\"customMeta\" data-dictid=\"ad09a76257169277719349e2735418\">nitrate</span> solution previously used for <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> immediately after birth <strong>(Option B): </strong>erythema, chemosis, lid edema, and <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> within the first<strong> 24 hours </strong>after birth.</li>\n</ul>\n</li>\n</ul>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Prophylaxis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Antenatal measures:\n\t\t\t\t<ul>\n<li>Treatment of <span class=\"customMeta\" data-dictid=\"0e919a208b16927771885d9c1f6662\">genital</span> infections and care of mother</li>\n<li>Surveillance of pregnant women for STDs</li>\n</ul>\n</li>\n<li>Natal measures:\n\t\t\t\t<ul>\n<li>Aseptic, <span class=\"customMeta\" data-dictid=\"fc3d080799169277719904701c07f9\">sterile</span> precautions to be followed during deliveries</li>\n<li>Clean the infant’s closed lids with <span class=\"customMeta\" data-dictid=\"fc3d080799169277719904701c07f9\">sterile</span> cotton soaked in <span class=\"customMeta\" data-dictid=\"ab6984f43316927771937ff19f3807\">normal saline</span> and dried</li>\n</ul>\n</li>\n<li>Post-natal measures:\n\t\t\t\t<ul>\n<li>Povidone-iodine 2.5% solution</li>\n<li>If the mother is under suspicion, 1% <span class=\"customMeta\" data-dictid=\"8784b5a7ad16927772005323b514b8\">tetracycline</span> or 0.5% <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> eye <span class=\"customMeta\" data-dictid=\"25ee86538e1692777194ef5ba9e4f1\">ointment</span> is used in the baby immediately after birth and watched for a week.</li>\n<li>Ceftriaxone 50mg/kg IM or IV single dose for infants born to mothers with untreated gonococcal infection.</li>\n</ul>\n</li>\n<li><strong>Crede’s method:</strong>\n<ul>\n<li>Old method using 1% silver <span class=\"customMeta\" data-dictid=\"ad09a76257169277719349e2735418\">nitrate</span> applied to infants' eyes right after birth</li>\n<li>It is not used now as it can cause chemical <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> conjunctivitis.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neisseria gonorrhoea </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ceftriaxone IM, <span class=\"customMeta\" data-dictid=\"ca244a562f16927771884ac81c7d2e\">gentamicin</span> drops, <span class=\"customMeta\" data-dictid=\"32ff1dc5e01692777182a5338b6367\">bacitracin</span> eye ointment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chemical </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Wash eyes, <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> ointment, observe</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other bacteria </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neomycin-bacitracin ointment, gentamicin, or <span class=\"customMeta\" data-dictid=\"23e84a422c1692777200166ff709ff\">tobramycin</span> drops</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Herpes simplex virus </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acyclovir 3% eye ointment, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"060850cb871692777180ce7d18e840\">acyclovir</span> (systemic involvement)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chlamydia trachomatis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Erythromycin or <span class=\"customMeta\" data-dictid=\"840aca53001692777184ed7e6cddf9\">chlortetracycline</span> eye ointment, oral <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> (systemic infection)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YLZObRSV1bMSOo6IZWv01746455441.mp3", "video": ""}, {"text": "A 64-year-old patient with dry eyes undergoes several tests. Which finding best supports the diagnosis of dry eye syndrome?", "options": [{"label": "A", "text": "Tear film break-up time of 15 seconds", "correct": false}, {"label": "B", "text": "Schirmer test showing 12 mm wetting", "correct": false}, {"label": "C", "text": "Extensive Rose Bengal staining", "correct": true}, {"label": "D", "text": "Normal tear film osmolality", "correct": false}], "correct_answer": "C. Extensive Rose Bengal staining", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/WHV3xItvt2AATu5ZzWGb1743177915.png", "https://image.prepladder.com/notes/9zVJL9051ud2wrqt7YEB1743177983.png", "https://image.prepladder.com/notes/L30dGkwcEPjpM6MUQcEn1743178044.png", "https://image.prepladder.com/notes/7XoEakhSMLZNct98rzu81743178124.png", "https://image.prepladder.com/notes/rP7y0qNLIsUCJzdOgoKG1743178214.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:713px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Slit-lamp examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Superficial corneal erosions</li>\n<li>Inadequate tear lake volume</li>\n<li>Early tear film break-up time</li>\n<li>Conjunctival hyperemia</li>\n<li>Conjunctival surface irregularities</li>\n<li>Meibomian <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> dysfunction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Schirmer’s Test:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Schirmer’s test is used to diagnose <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> <span class=\"customMeta\" data-dictid=\"9a642d93fd1692777186d5345e0634\">dry eye</span> disease.</li>\n</ul>\n<p><strong>Schirmer's Test 1</strong></p>\n<ul>\n<li>Measures both <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> and <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> tear secretions</li>\n<li>Uses Whatman-41 filter paper, kept in the lower <span class=\"customMeta\" data-dictid=\"a17eac40ea16927772034ca233cb84\">fornix</span> at the <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> of <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> one-third and <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> two-thirds.</li>\n<li>After 5 minutes, wetting of the filter strip from the bent end is measured.</li>\n<li>Normal value: &gt;15 mm</li>\n<li>5-10 mm: Mild to moderate <span class=\"customMeta\" data-dictid=\"8b4e6e36bb169277719032f22681c2\">keratoconjunctivitis</span> sicca (KCS).</li>\n<li>&lt; 5 mm: Severe KCS <strong>(Option B)</strong></li>\n</ul>\n<p> </p>\n<p><strong>Schirmer's Test 2</strong></p>\n<ul>\n<li>Measures only <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> under anesthesia</li>\n</ul>\n<p> </p>\n<p><img alt=\"Schrimer test\" data-author=\"Dominika Wróbel-Dudzińska, Agnieszka Kubik-Komar, Dorota Rykwa, Ewa Kosior-Jarecka, Tomasz Żarnowski &amp; Renata Chałas \" data-hash=\"4583\" data-license=\"CC BY 3.0\" data-source=\"https://link.springer.com/article/10.1007/s00784-020-03741-3#rightslink\" data-tags=\"March2025\" height=\"684\" src=\"https://image.prepladder.com/notes/WHV3xItvt2AATu5ZzWGb1743177915.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phenol Red Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A modified Schirmer’s test using a cotton thread impregnated with <span class=\"customMeta\" data-dictid=\"0d5565e4a1169277719596227ebffd\">phenol</span> red dye.</li>\n<li>The thread is placed in the lower <span class=\"customMeta\" data-dictid=\"a17eac40ea16927772034ca233cb84\">fornix</span> for 15 seconds.</li>\n<li>Phenol <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> changes from yellow to red depending on the pH of the tears.</li>\n<li>Wet length: &gt;20 mm: Normal.</li>\n<li>&lt;10 mm: Severe dry eye.</li>\n<li>≤19 mm as <span class=\"customMeta\" data-dictid=\"2d896c605a1692777183d769916056\">borderline</span> dry eye.<strong> </strong></li>\n</ul>\n<p><img alt=\"Phenol_red_thread_testing\" data-author=\"Sarah Dougherty Wood, Shahzad I Mian\" data-hash=\"4584\" data-license=\"CC BY NC \" data-source=\"https://www.touchophthalmology.com/anterior-segment/journal-articles/diagnostic-tools-for-dry-eye-disease/\" data-tags=\"March2025\" height=\"413\" src=\"https://image.prepladder.com/notes/9zVJL9051ud2wrqt7YEB1743177983.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tear Film Break-Up Time (TBUT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tear film stained with sodium <span class=\"customMeta\" data-dictid=\"468accc4d3169277720252132f5b85\">fluorescein</span> 1% is observed under a <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp, and time is noted after the patient blinks.</li>\n<li>The interval between the complete blink and the first appearance of a ‘dark’ dry spot on the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is recorded as TBUT.</li>\n<li>It is an indicator of the <span class=\"customMeta\" data-dictid=\"fc82a39c2a16927771807cea91e4a6\">adequacy</span> of the <span class=\"customMeta\" data-dictid=\"7d30ef9aee16927771936bdac2c1ff\">mucin</span> component of tears.</li>\n<li>Normal: 15-35 seconds</li>\n<li>&lt; 10 seconds indicates unstable tear film. <strong>(Option A)</strong></li>\n</ul>\n<p><img alt=\"Tear Film Break-Up Time\" data-author=\"Louis Tong, Li Lim, Donald Tiang Hwee Tan, Wee Jin Heng, Jimmy Lim, Cordelia Chan, Anshu Arundhati, Anna Tan\" data-hash=\"4585\" data-license=\"CC BY NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Four-patterns-of-tear-film-breakup-clinically-observed-Image-from-Yokoi-N-Georgiev-AG_fig1_356147026\" data-tags=\"March2025\" height=\"33\" src=\"https://image.prepladder.com/notes/L30dGkwcEPjpM6MUQcEn1743178044.png\" width=\"500\"/></p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rose Bengal</strong><strong> or Lissamine Green</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stain devitalized, desiccated corneal and conjunctival <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> red or green. <strong>(Option C) </strong><strong> </strong></p>\n<p><strong>Rose Bengal stain</strong><img alt=\"Rose bengal stain\" data-author=\"Jesse Vislisel, MD, Stefani Karakas, CRA\" data-hash=\"4586\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/Rose-Bengal/index.htm#gsc.tab=0\" data-tags=\"March2025\" height=\"335\" src=\"https://image.prepladder.com/notes/7XoEakhSMLZNct98rzu81743178124.png\" width=\"500\"/></p>\n<p><strong>Lissamine Green</strong></p>\n<p><img alt=\"Lissamine green stain\" data-author=\"Carolyn Begley, Barbara Caffery, Robin Chalmers, Ping Situ, Trefford Simpson, J. Daniel Nelson\" data-hash=\"4587\" data-license=\"CC BY NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Lissamine-green-dye-visibility-over-time-In-the-top-patient-staining-and-some-dye_fig5_330393110\" data-tags=\"March2025\" height=\"407\" src=\"https://image.prepladder.com/notes/rP7y0qNLIsUCJzdOgoKG1743178214.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alcian Blue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stains <span class=\"customMeta\" data-dictid=\"d4226a4b2e169277719459bb9339d6\">particulate</span> matter in the tear film due to mucus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tear film Osmolality</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased in <span class=\"customMeta\" data-dictid=\"9a642d93fd1692777186d5345e0634\">dry eye</span> <strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tear to Lysozyme ratio</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Between 0.9 and 0.6 indicates dry eye.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/m6T6LAyYCwWUOV0PtIDK1747383816.mp3", "video": ""}, {"text": "A 60-year-old patient diagnosed with dry eye syndrome asks about the typical features of the condition. Which of the following is not commonly associated with dry eye?", "options": [{"label": "A", "text": "Frothy tears along the lid margin", "correct": false}, {"label": "B", "text": "Punctate epithelial erosions on the cornea", "correct": false}, {"label": "C", "text": "Conjunctival xerosis and keratinization", "correct": false}, {"label": "D", "text": "Follicles on the conjunctiva", "correct": true}], "correct_answer": "D. Follicles on the conjunctiva", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ISQYLFQXlc0WyuxFxZKA1743177757.png", "https://image.prepladder.com/notes/19vlzbtHt9dx9sHxXYSM1743177804.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4vMGvXVHgGYO0XBTo8gj1747384122.mp3", "video": ""}, {"text": "A 65-year-old woman with rheumatoid arthritis presents with dry eyes and mouth. Rose bengal staining shows conjunctival damage, and tear analysis reveals a tear-to-lysozyme ratio of 0.1. Which tear film layer is primarily deficient in this condition?", "options": [{"label": "A", "text": "Mucinous layer", "correct": false}, {"label": "B", "text": "Aqueous layer", "correct": true}, {"label": "C", "text": "Lipid layer", "correct": false}, {"label": "D", "text": "All layers are equally affected", "correct": false}], "correct_answer": "B. Aqueous layer", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/OPZvRmFvOAdh4G0q2F2H1743177675.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:640px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tear Film Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Secreted By</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Function </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Defective in </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Innermost Mucinous Layer</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Goblet cells, crypts of Henle, Manz’s glands</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Convert <span class=\"customMeta\" data-dictid=\"e3be2eb847169277718953f0dae57d\">hydrophobic</span> corneal surface into <span class=\"customMeta\" data-dictid=\"db283047011692777189a869dbce07\">hydrophilic</span> one</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitamin A deficiency</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Middle <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">Aqueous</span> Layer</strong></p>\n<p><strong>(thickest layer) </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lacrimal and <span class=\"customMeta\" data-dictid=\"9088e1c7f616927771802e7f6d2541\">accessory</span> conjunctival glands (Krause, Wolfring/Ciaccio)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contain tears</li>\n<li>Also contains <span class=\"customMeta\" data-dictid=\"663cbd38e41692777181d697c66bd0\">antibacterial</span> substances like lysozyme, beta-lysin, and lactoferrin.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sjogren’s syndrome</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Outermost Lipid Layer</strong></p>\n<p><strong>(thinnest layer)</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Meibomian glands</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prevent <span class=\"customMeta\" data-dictid=\"c2c7c471601692777194cbef97853e\">overflow</span> of tears.</li>\n<li>Retard evaporation.</li>\n<li>Lubricates the eyelids.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contact lens wear</li>\n<li>Meibomian <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> defect</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Keratoconjunctivitis sicca (sjögren syndrome)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Condition caused by <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> of the <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> component of <span class=\"customMeta\" data-dictid=\"1717bdb5d21692777200d45e31ceed\">tears</span> due to impaired <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> secretion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lacrimal glands show <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> and lymphocytic infiltration.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Occurs in</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Postmenopausal women are often associated with <span class=\"customMeta\" data-dictid=\"40dbde72e41692777197e59d893839\">rheumatoid</span> arthritis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Eye dryness</li>\n<li>Irritative symptoms</li>\n<li>Epithelial erosions or filaments on the corneal surface</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Damage to the corneal and conjunctival <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> can be seen with Rose bengal staining.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tear Composition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Typical tear to <span class=\"customMeta\" data-dictid=\"ab1f64ccf31692777191d3b190845b\">lysozyme</span> ratio of 0.1.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Qqje6nfRGhWSlgLYhZtq1747384740.mp3", "video": ""}, {"text": "A 70-year-old man with extensive sun exposure has a yellowish, triangular patch on the nasal conjunctiva, as shown below. The lesion does not extend onto the cornea. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pterygium", "correct": false}, {"label": "B", "text": "Pinguecula", "correct": true}, {"label": "C", "text": "Dermoid", "correct": false}, {"label": "D", "text": "Malignant melanoma", "correct": false}], "correct_answer": "B. Pinguecula", "question_images": ["https://image.prepladder.com/notes/iFMN6V6fTSo0dijJqjdG1747398016.png"], "explanation_images": ["https://image.prepladder.com/notes/iFMN6V6fTSo0dijJqjdG1747398016.png", "https://image.prepladder.com/notes/4xmFXnFNTzxji5ZtzRRa1743176688.png", "https://image.prepladder.com/notes/pZS3fUHtTs06ixo5RS5I1743177504.png", "https://image.prepladder.com/notes/AqyECnkYwN7F9Hnjs8Cc1743177571.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pinguecula</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A triangular patch on the <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> appears yellow and resembles fat (pinguis).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Caused by <span class=\"customMeta\" data-dictid=\"a2ce88e8a0169277718988f5bc31b8\">hyaline</span> <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> and <span class=\"customMeta\" data-dictid=\"6dd3573672169277718784fd1574fb\">elastotic</span> <span class=\"customMeta\" data-dictid=\"df4f1758e2169277718697ae66f3dd\">degeneration</span> of <span class=\"customMeta\" data-dictid=\"b49bba8e8a16927771997b281fd66a\">submucous</span> tissue.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common in elderly people, particularly those exposed to strong sunlight, dust, and wind.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bilateral</li>\n<li>Usually stationary</li>\n<li>Yellowish triangular patch near the limbus</li>\n<li>Apex of the <span class=\"customMeta\" data-dictid=\"d398f22bb71692777201622867bda7\">triangle</span> is away from the cornea</li>\n<li>Affects the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> side first, followed by the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> side</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"Pinguecula\" data-author=\"\" data-hash=\"12861\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/iFMN6V6fTSo0dijJqjdG1747398016.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complication </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inflammation of pinguecula</li>\n<li>Intraepithelial <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> formation</li>\n<li>Rarely calcification</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Generally, it requires no treatment.</li>\n<li>When inflamed, treated with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> steroids.</li>\n<li>May be excised when cosmetically unaccepted.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/cWUXXyI740kKcAEOS0hf1747382909.mp3", "video": ""}, {"text": "A 50-year-old male comes to the clinic with complaints of a small fleshy triangular mass in the eye. There is no history of pain or discharge. On examination, it is as in the image. What is true about this lesion?", "options": [{"label": "A", "text": "This is a non-progressive lesion", "correct": false}, {"label": "B", "text": "It can be present in any quadrant of the eye", "correct": false}, {"label": "C", "text": "It is caused by thermochemical burn, trauma, and chronic inflammation", "correct": false}, {"label": "D", "text": "Histology shows collagenous degenerative changes in the vascularized subepithelial stroma", "correct": true}], "correct_answer": "D. Histology shows collagenous degenerative changes in the vascularized subepithelial stroma", "question_images": ["https://image.prepladder.com/notes/4xmFXnFNTzxji5ZtzRRa1743176688.png"], "explanation_images": ["https://image.prepladder.com/notes/D96pGA6dVCnxZf9Cerl01743176762.png", "https://image.prepladder.com/notes/zhFAXzeXi8uF5e0eVvfh1743176903.png", "https://image.prepladder.com/notes/8QCCDekWptMXh4wpTtWj1743176821.png", "https://image.prepladder.com/notes/jsbk1FIRgsw6A72Wz4Yg1743176973.png", "https://image.prepladder.com/notes/1sCw6UEAz3Yn648RIhWD1743177036.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:714px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pterygium/Surfer’s eye</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pseudopterygium</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pterygium is a triangular encroachment of vascularized <span class=\"customMeta\" data-dictid=\"09e414c5a71692777188ef029aefe5\">granulation</span> tissue covered by <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> in the <span class=\"customMeta\" data-dictid=\"f2a86bcac91692777190f5db6b96ca\">interpalpebral</span> area.</p>\n<img alt=\" Parts of pterygium\" data-author=\"NA\" data-hash=\"4560\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/D96pGA6dVCnxZf9Cerl01743176762.png\" width=\"500\"/><br/>\n<br/>\n\t\t\t \n\t\t\t<ul>\n<li>Parts: Cap, head, neck, body</li>\n<li><strong>Degenerative </strong>process</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pterygium like lesion</li>\n<li>Due to cicatrizing conjunctival <strong>inflammatory </strong>overgrowth.</li>\n</ul>\n<p><img alt=\"Pseudopterygium\" data-author=\" Facundo Urbinati, Davide Borroni, Marina Rodríguez-Calvo-de-Mora, José-María Sánchez-González, María García-Lorente, Francisco Zamorano-Martín, Rahul Rachwani-Anil, Santiago Ortiz-Pérez, Vito Romano and Carlos Rocha-de-Lossada \" data-hash=\"4562\" data-license=\"open access\" data-source=\"https://www.mdpi.com/2075-4418/12/8/1843\" data-tags=\"March2025\" height=\"412\" src=\"https://image.prepladder.com/notes/zhFAXzeXi8uF5e0eVvfh1743176903.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Aetiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Common in dry, sunny climates with sandy soils</li>\n<li><strong>Ultraviolet light </strong>is a probable factor</li>\n<li>Usually elderly persons</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Seen at any age</li>\n<li>Caused by <strong> (Option C)</strong>\n<ul>\n<li>Trauma</li>\n<li>Chronic conjunctivitis</li>\n<li>Thermochemical burn</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Pathology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p>Histology shows <strong>collagenous degenerative changes in the vascularized <span class=\"customMeta\" data-dictid=\"94aff4fd141692777199a78b5ed2eb\">subepithelial</span> stroma.</strong></p>\n<p><img alt=\"Pterygium histology\" data-author=\"Nephron\" data-hash=\"4561\" data-license=\"CC BY SA 3.0\" data-source=\"https://librepathology.org/wiki/File:Pterygium_-_high_mag.jpg\" data-tags=\"March2025\" height=\"335\" src=\"https://image.prepladder.com/notes/8QCCDekWptMXh4wpTtWj1743176821.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Pathogenesis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Degenerative <span class=\"customMeta\" data-dictid=\"335f16a33c16927771992f5c55bc4d\">subconjunctival</span> proliferation</li>\n<li>Granulation tissue proliferates as avascularized tissue encroaches on the cornea.</li>\n<li>Destroys the <strong>superficial layers of the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> and Bowman’s membrane</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Frequently follows a pinguecula</li>\n<li>Often bilateral</li>\n<li>Usually on the <strong>nasal side</strong> <strong> (Option B)</strong></li>\n<li>Impairment of vision due to:\n\t\t\t\t<ul>\n<li>Progression into the pupillary area of the cornea</li>\n<li>Induced <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> by corneal <span class=\"customMeta\" data-dictid=\"13d0edf82916927772021bfc7f9aeb\">flattening</span> in the <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> of pterygium</li>\n</ul>\n</li>\n<li><strong>Progressive </strong>pterygium: thick and vascular</li>\n<li><strong>Regressive </strong>pterygium: thin, pale, and atrophic</li>\n<li>Ceases to grow but never disappears</li>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the lesion</li>\n<li>Can present as <strong>inflammed pterygium</strong></li>\n</ul>\n<p><img alt=\"Inflammed pterygium\" data-author=\"Nephron\" data-hash=\"4563\" data-license=\"CC BY SA 3.0\" data-source=\"https://librepathology.org/wiki/File:Pterygium_-_high_mag.jpg\" data-tags=\"March2025\" height=\"381\" src=\"https://image.prepladder.com/notes/jsbk1FIRgsw6A72Wz4Yg1743176973.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Non-progressive </strong><strong>(Option A)</strong></li>\n<li>Can be at <strong>any quadrant</strong> of the corneal limbus</li>\n<li>Located away from the horizontal</li>\n<li>Attached to the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> due to <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> tissue</li>\n<li>Adhered to the adjacent lid</li>\n<li>Always <strong>stationary</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> cannot be passed under the lesion</li>\n<li><strong>Fusch’s spots/Islets of Vogt:</strong> small <span class=\"customMeta\" data-dictid=\"635650799116927771862d7cb568f4\">discrete</span> whitish flecks made of pterygial epithelial cells seen in progressive <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> and are also called the <strong>cap </strong>of the pterygium.</li>\n<li><strong>Stocker line: </strong>linear epithelial iron deposition, seen in <span class=\"customMeta\" data-dictid=\"531cf746021692777197c135fbce82\">regressive</span> pterygium.</li>\n</ul>\n<p><img alt=\"Stockers-line\" data-author=\"Jonathan Trobe, M.D\" data-hash=\"4566\" data-license=\"CC BY 3.0\" data-source=\"https://en.wikipedia.org/wiki/Pterygium_(eye)#/media/File:Pterygium_(from_Michigan_Uni_site,_CC-BY).jpg\" data-tags=\"March2025\" height=\"212\" src=\"https://image.prepladder.com/notes/1sCw6UEAz3Yn648RIhWD1743177036.png\" width=\"500\"/></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the neck.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PiPJgrInGHl2vwWNsKYz1747381887.mp3", "video": ""}, {"text": "A 25-year-old male presents with difficulty seeing at night. Which of the following is not a cause of nyctalopia (night blindness)?", "options": [{"label": "A", "text": "Gyrate atrophy", "correct": false}, {"label": "B", "text": "Pathological myopia", "correct": false}, {"label": "C", "text": "Cone dystrophy", "correct": true}, {"label": "D", "text": "Choroideremia", "correct": false}], "correct_answer": "C. Cone dystrophy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/P4TlGMkF06tucDOrokiE1743161968.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5WbAwOFJJ782qDvlGGfC1747381439.mp3", "video": ""}, {"text": "A 3-year-old child presents with symptoms of night blindness and dry eyes. On examination, there are Bitot's spots on the temporal side of both eyes. The child’s guardian reports that the child has had a history of frequent respiratory infections. What is the most appropriate treatment regimen to prevent further ocular complications?", "options": [{"label": "A", "text": "100,000 IU of vitamin A orally on diagnosis, next day, and after 2 weeks.", "correct": false}, {"label": "B", "text": "Vitamin A eye drops and 10,000 IU orally for 1 month.", "correct": false}, {"label": "C", "text": "200,000 IU of vitamin A orally on diagnosis, next day, and after 2 weeks.", "correct": true}, {"label": "D", "text": "Oral multivitamins with increased vitamin A-rich foods for 3 months.", "correct": false}], "correct_answer": "C. 200,000 IU of vitamin A orally on diagnosis, next day, and after 2 weeks.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:705px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Population</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Vitamin A Dose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Treatment regimen</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Children (≥1 year)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>200,000 IU orally on diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Day1, Day 2, and 2 weeks later <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Children (Infants under 12 months)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>100,000 IU orally</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Day1, Day 2, and 2 weeks later <strong>(Options A and B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Adults (non-pregnant)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>200,000 IU orally</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>200,000 IU orally on Day 1, Day 2, and after 2 weeks.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Pregnant Women</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>10,000 IU orally daily</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Daily oral administration of 10,000 IU for 1 month</p>\n<p>(due to the risk of teratogenicity, higher doses are avoided during pregnancy).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Lactating Women</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>200,000 IU orally</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>One dose of 200,000 IU orally</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8MOLSJKcaEsUavwFnNpU1747381149.mp3", "video": ""}, {"text": "A 5-year-old boy from a rural area has difficulty seeing at night. Upon examination, you notice the presence of triangular, dry-white spots on the bulbar conjunctiva in both eyes. Which of the following represents the correct diagnosis and grade of xerophthalmia based on the clinical findings?", "options": [{"label": "A", "text": "Night Blindness (XN)", "correct": false}, {"label": "B", "text": "Conjunctival Xerosis (X1A)", "correct": false}, {"label": "C", "text": "Bitot’s Spots (X1B)", "correct": true}, {"label": "D", "text": "Corneal Xerosis (X2)", "correct": false}], "correct_answer": "C. Bitot’s Spots (X1B)", "question_images": ["https://image.prepladder.com/notes/9s98duALEvXvsL2ZoHaS1747396961.png"], "explanation_images": ["https://image.prepladder.com/notes/10Z2pFzSzSiaFWzQLbpa1743161572.png", "https://image.prepladder.com/notes/9s98duALEvXvsL2ZoHaS1747396961.png", "https://image.prepladder.com/notes/oi4dYRliUcbg6kCIBsBo1743161692.png", "https://image.prepladder.com/notes/JGd91bioHIOus9HoBfv51743161780.png", "https://image.prepladder.com/notes/3sHcqb3HJqKO9rzHI5j51743161850.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:641px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Grade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Image</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>XN (Night Blindness)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Difficulty seeing in low light (night blindness).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Normal conjunctiva, early visual <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> in low light conditions.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Nyctalopia: The earliest sign</strong> of xerophthalmia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>X1A (Conjunctival Xerosis)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Dry eyes, lusterless appearance.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Non-wettable, dry <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> affecting the <span class=\"customMeta\" data-dictid=\"f2a86bcac91692777190f5db6b96ca\">interpalpebral</span> area, resembling \"sandbanks\".</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Conjunctival-xerosis\" data-author=\"Hung-Yuan Hsu, I-Lun Tsai, Li-Lin Kuo, Ching-Yao Tsai, Shiow-Wen Liou, Lin-Chung Woung\" data-hash=\"4415\" data-license=\"CC BY-NC-ND 4.0\" data-source=\"https://www.researchgate.net/figure/Conjunctival-xerosis-represents-scaly-dry-and-keratinized-conjunctiva_fig5_272101976\" data-tags=\"March2025\" height=\"370\" src=\"https://image.prepladder.com/notes/10Z2pFzSzSiaFWzQLbpa1743161572.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>X1B (Bitot’s Spots)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Mild irritation, possibly no symptoms.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Triangular, dry-white masses on the <span class=\"customMeta\" data-dictid=\"ef00544aba1692777183bc916b1c30\">bulbar</span> conjunctiva, usually <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> and temporal.</li>\n<li>Bitot's spot consists of <strong>keratinized epithelium.</strong></li>\n<li>Associated with <strong>Corynebacterium infection</strong></li>\n<li>More common on the <strong>temporal side</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Bitot's spot\" data-author=\"\" data-hash=\"12860\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/9s98duALEvXvsL2ZoHaS1747396961.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>X2 (Corneal Xerosis)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Blurred vision, and eye dryness.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Punctate keratopathy, hazy <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> with <span class=\"customMeta\" data-dictid=\"4f63eb15be169277718848d4b4978b\">granular</span> and xerotic changes, beginning from the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> quadrant.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Corneal xerosis\" data-author=\"Hung-Yuan Hsu, I-Lun Tsai, Li-Lin Kuo, Ching-Yao Tsai, Shiow-Wen Liou, Lin-Chung Woung\" data-hash=\"4418\" data-license=\"CC BY-NC-ND 4.0\" data-source=\"https://www.researchgate.net/figure/fig3_272101976\" data-tags=\"March2025\" height=\"343\" src=\"https://image.prepladder.com/notes/oi4dYRliUcbg6kCIBsBo1743161692.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>X3 (Corneal Ulceration &amp; Scarring)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Severe eye pain, and visual impairment.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Collagen <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> leads to sharply demarcated corneal ulcers, corneal scarring, and opacity.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Corneal_opacity\" data-author=\"Ajeeshkumar4u\" data-hash=\"4421\" data-license=\"CC BY-SA 4.0\" data-source=\"https://en.wikipedia.org/wiki/Corneal_opacity#/media/File:Corneal_opacity_right_eye_2.jpg\" data-tags=\"March2025\" height=\"221\" src=\"https://image.prepladder.com/notes/JGd91bioHIOus9HoBfv51743161780.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>XF (Xerophthalmic Fundus)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Visual impairment, difficulty with central vision.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Whitish, seed-like, raised lesions scattered in the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> near the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Xerophthalmic fundus\" data-author=\"Jason Allan Seng Soon Cheah, Julieana Muhammed, Sangeetha Tharmathurai, Norhafizah Hamzah, Jamalia Rahmat\" data-hash=\"4422\" data-license=\"CC BY 4.0\" data-source=\"https://www.cureus.com/articles/85082-optic-neuropathy-in-an-autistic-child-with-vitamin-a-deficiency-a-case-report-and-literature-review#!/\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/3sHcqb3HJqKO9rzHI5j51743161850.png\" width=\"500\"/></td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pyaLWXQFv2QUhXKeyPgv1747380843.mp3", "video": ""}, {"text": "A 23-year-old male presents with a history of atopic dermatitis and asthma. He complains of tearing, burning, itching sensation and blurry vision for the past week. On examination, his eyelids are thickened and swollen, with signs of meibomitis. Slit-lamp examination reveals anterior subcapsular cataracts. What is the most appropriate first-line treatment for this patient’s ocular symptoms?", "options": [{"label": "A", "text": "Topical corticosteroids", "correct": false}, {"label": "B", "text": "Topical dual-acting antihistamine/mast cell stabilizer", "correct": true}, {"label": "C", "text": "Topical cyclosporine", "correct": false}, {"label": "D", "text": "Oral antihistamines", "correct": false}], "correct_answer": "B. Topical dual-acting antihistamine/mast cell stabilizer", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/IPjX8BOXNpiZbRAXNHnd1743161219.png", "https://image.prepladder.com/notes/WBA0ojKTf0UcQWM8LFRn1743161301.png", "https://image.prepladder.com/notes/qhHZxK8lwCoiuolw7uHa1743161364.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:657px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Atopic Keratoconjunctivitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Patient demographics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Common in young adults, often associated with a <strong>family history of <span class=\"customMeta\" data-dictid=\"afad60190f1692777182663499dc42\">atopic</span> conditions s</strong>uch as asthma, allergic rhinitis, or <span class=\"customMeta\" data-dictid=\"afad60190f1692777182663499dc42\">atopic</span> dermatitis.</p>\n<p>Prevalent during winter months.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Disease characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Severe, chronic <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> surface disorder with a range of severity from mild to persistent <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and extends into adulthood.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Characteristic findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Symptoms; </strong>Tearing, burning, itching, clear <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> discharge,</p>\n<p>Blurry vision, photophobia, foreign body sensation</p>\n<p><strong>Shield cataract/Atopic <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong>(anterior or <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> subcapsular)</p>\n<p><img alt=\"Shield cataract\" data-author=\"Gonzalo García de Oteyza, Ana Mercedes García-Albisua\" data-hash=\"4409\" data-license=\"NA\" data-source=\"https://www.canadianjournalofophthalmology.ca/article/S0008-4182(21)00071-5/abstract\" data-tags=\"March2025\" height=\"490\" src=\"https://image.prepladder.com/notes/IPjX8BOXNpiZbRAXNHnd1743161219.png\" width=\"500\"/></p>\n<p><strong>Eyelid Changes:</strong></p>\n<ul>\n<li>Thickened, swollen eyelids (intermittent due to chronic inflammation).</li>\n<li>Lichenified and woody eyelids leading to Cicatricial <span class=\"customMeta\" data-dictid=\"410b701d9916927771861ac447b041\">ectropion</span> and lagophthalmos</li>\n<li>Madarosis.</li>\n<li>Meibomitis and blepharitis</li>\n<li><strong>Dennie Morgan folds</strong>: Skin folds under the eyes due to excessive rubbing.</li>\n</ul>\n<p><img alt=\"Dennie-Morgan-Folds\" data-author=\"Splatter girl\" data-hash=\"4410\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Dennie%E2%80%93Morgan_fold#/media/File:Dennie-Morgan-Falte.jpg\" data-tags=\"March2025\" height=\"405\" src=\"https://image.prepladder.com/notes/WBA0ojKTf0UcQWM8LFRn1743161301.png\" width=\"500\"/></p>\n<ul>\n<li><strong>Hertoghe's sign</strong>: Loss of the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> third of the eyebrows</li>\n</ul>\n<p><img alt=\"Herthoge_s sign\" data-author=\"Betty Nguyen, Jamie Katy Hu &amp; Antonella Tosti\" data-hash=\"4411\" data-license=\"CC BY NC 4.0\" data-source=\"https://link.springer.com/article/10.1007/s40257-022-00729-5#rightslink\" data-tags=\"March2025\" height=\"360\" src=\"https://image.prepladder.com/notes/qhHZxK8lwCoiuolw7uHa1743161364.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>First-line therapy: <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">Topical</span> dual-acting antihistamine/mast cell stabilizer</li>\n<li>If there is no improvement in 2-3 weeks: A brief course of <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> corticosteroids. <strong>(Option A)</strong></li>\n<li>For moderate-to-severe disease requiring frequent corticosteroids - Use <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> <span class=\"customMeta\" data-dictid=\"fa041055ec16927771858fe49c76d3\">cyclosporine</span> (2%, compounded). <strong>(Option C)</strong></li>\n<li>Eyelid Dermatitis: <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">Topical</span> <span class=\"customMeta\" data-dictid=\"c156680d2216927772004a7846ad8e\">tacrolimus</span> is preferred over corticosteroids.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/O7zSfHPxL2ZAm56e6d5C1747301872.mp3", "video": ""}, {"text": "A 10-year-old child presents with itching, watering, and redness in both eyes. On examination, small round yellow nodules are observed near the limbus, and conjunctival congestion is noted. The child has a past h/o TB. Which of the following best explains the pathophysiology of this condition?", "options": [{"label": "A", "text": "Type I hypersensitivity reaction caused by environmental allergens", "correct": false}, {"label": "B", "text": "Type IV hypersensitivity reaction to endogenous bacterial antigens", "correct": true}, {"label": "C", "text": "Type II hypersensitivity reaction triggered by viral infections", "correct": false}, {"label": "D", "text": "Autoimmune reaction against corneal epithelial cells", "correct": false}], "correct_answer": "B. Type IV hypersensitivity reaction to endogenous bacterial antigens", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/j1Iea9foWtdKwOhesvKS1747313802.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Phlyctenular keratoconjunctivitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Allergic reactions to <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> antigens are often <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to bacterial infections such as <strong>Staphylococcus aureus </strong>(M/C/C in Western countries)<strong> </strong> or <strong>tuberculosis</strong>(M/C/C in India).</p>\n<p> </p>\n<p><img alt=\"Phlyctenular Keratoconjunctivitis\" data-author=\"\" data-hash=\"12790\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/j1Iea9foWtdKwOhesvKS1747313802.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Symptoms &amp; signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Watering, itching</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"540b75eeb516927771831794d7ce0f\">blepharospasm</span> (involuntary blinking)</li>\n<li>Conjunctival congestion</li>\n<li><strong>Phlycten - Small, round, grayish, or yellowish nodules on the <span class=\"customMeta\" data-dictid=\"ef00544aba1692777183bc916b1c30\">bulbar</span> <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> near the limbus</strong>.</li>\n<li>Corneal involvement can lead to <span class=\"customMeta\" data-dictid=\"ee875e7c3416927772026804e2e155\">fascicular</span> ulcers or ring ulcers.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Type IV <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reaction.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Common Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Corneal involvement:</strong> Ulcers <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> on the cornea, leading to potential scarring.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Associated Conditions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Long-standing mild infections like <strong>tonsillitis</strong> or <strong>adenoiditis</strong>, and in populations with a high <span class=\"customMeta\" data-dictid=\"f86aae0bd61692777196f91458c9dd\">prevalence</span> of <strong>tuberculosis</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Local therapy:</strong></p>\n<ul>\n<li>Corticosteroids: Drops/ointment to reduce inflammation. Address underlying cause (e.g., tuberculosis).</li>\n<li>Antibiotics</li>\n<li>Cycloplegics: Paralyze <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle, relieve pain, and prevent complications.</li>\n<li>Dark Glasses/Eye Shade: For <span class=\"customMeta\" data-dictid=\"46e2a1c298169277719583f46ff587\">photophobia</span> relief.</li>\n</ul>\n<p><strong>General therapy:</strong></p>\n<ul>\n<li>Oral <span class=\"customMeta\" data-dictid=\"8784b5a7ad16927772005323b514b8\">tetracycline</span> or <span class=\"customMeta\" data-dictid=\"d0f202322516927771863db87b76e7\">doxycycline</span> is used in <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> cases <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to Staphylococcal blepharitis.</li>\n</ul>\n<p><strong>Supportive:</strong> Dark <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> or eye shade.</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VMZH7mx9YXdPJb8ZUvSz1747301310.mp3", "video": ""}, {"text": "A 6-year-old boy presents with a 2-week history of worsening bilateral eye redness, itching, and frequent lacrimation. On examination, hypertrophied, cobblestone-like papillae is seen on the palpebral conjunctiva. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Atopic Keratoconjunctivitis", "correct": false}, {"label": "B", "text": "Vernal Keratoconjunctivitis", "correct": true}, {"label": "C", "text": "Bacterial Conjunctivitis", "correct": false}, {"label": "D", "text": "Chlamydial Conjunctivitis", "correct": false}], "correct_answer": "B. Vernal Keratoconjunctivitis", "question_images": ["https://image.prepladder.com/notes/TnmXSy6i0DsGdRC7edWa1743159536.png"], "explanation_images": ["https://image.prepladder.com/notes/sLqJ5yQU2uHGYFBiVZbE1743159637.png", "https://image.prepladder.com/notes/cwUY0kxSnIyxGTtD7m7u1743159701.png", "https://image.prepladder.com/notes/sIj75u8g1hGDT5pTqhhq1743159790.png", "https://image.prepladder.com/notes/Ex6h40HVqEAqfIkChJOJ1743159861.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:686px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Vernal <span class=\"customMeta\" data-dictid=\"8b4e6e36bb169277719032f22681c2\">keratoconjunctivitis</span> or Spring catarrh</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>It is a <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> that tends to occur with the onset of warm weather. It primarily affects young children and adolescents, particularly boys.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Course </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>The condition typically starts in childhood and may resolve on its own over 5–10 years.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Burning, Itching, Photophobia (sensitivity to light), and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> (excessive tearing).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>Palpebral Form</strong>: Hypertrophied palpebral <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> with a cobblestone appearance;dense <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> tissue with thickened epithelium.</li>\n<li><strong>Limbal </strong>or <strong>Bulbar Form</strong>: Opacification at the limbus, <span class=\"customMeta\" data-dictid=\"be6fe9c6c316927771889dbaaf2b89\">gelatinous</span> thickening, and Horner–Trantas dots</li>\n</ul>\n<img alt=\"Horner-Trantas-dots\" data-author=\"Jodhbir Singh Mehta, Wei-Li Chen, Arthur C. K. Cheng, Le Xuan Cung, Ivo J. Dualan, Ramesh Kekunnaya, Nurliza Khaliddin, Tae-Im Kim, Douglas K. Lam, Seo Wei Leo, Florence Manurung, Nattaporn Tesavibul, Dominique Bremond-Gignac\" data-hash=\"4400\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Horner-Trantas-dots-Peri-limbal-Horner-Trantas-dots-are-focal-white-dots-consisting-of_fig5_362403730\" data-tags=\"March2025\" height=\"110\" src=\"https://image.prepladder.com/notes/sLqJ5yQU2uHGYFBiVZbE1743159637.png\" width=\"500\"/>\n<ul>\n<li>Pseudogerontoxon/cupid’s bow (which resembles <span class=\"customMeta\" data-dictid=\"e11c93da8d1692777182758f2163d6\">arcus</span> senilis) is a grayish-white ring at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> seen in severe <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> <span class=\"customMeta\" data-dictid=\"b2a2e3ba5c1692777201528ac05837\">vernal</span> <span class=\"customMeta\" data-dictid=\"8b4e6e36bb169277719032f22681c2\">keratoconjunctivitis</span> (VKC).</li>\n</ul>\n\t\t\t <img alt=\"pseudogerontoxon\" data-author=\"Seyfettin Erdem\" data-hash=\"4401\" data-license=\"CC BY NC 4.0\" data-source=\"https://www.researchgate.net/figure/Limbal-type-VKC-pseudogerontoxone-image-palpebral-papilla-64-patients-447-limbal_fig3_336972956\" data-tags=\"March2025\" height=\"296\" src=\"https://image.prepladder.com/notes/cwUY0kxSnIyxGTtD7m7u1743159701.png\" width=\"500\"/>\n<ul>\n<li>Shield ulcers are a significant <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> of VKC, particularly in severe cases. These microerosions typically <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> on the upper third of the cornea.</li>\n</ul>\n\t\t\t <img alt=\"Sheild ulcer\" data-author=\"Yusuke Matsuzaki, Hiroshi Toshida, Toshihiko Ohta, Akira Murakami\" data-hash=\"4402\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Slitlamp-microscopic-image-of-a-25-year-old-man-showing-corneal-shield-ulcer-at-40-days_fig1_236941145\" data-tags=\"March2025\" height=\"382\" src=\"https://image.prepladder.com/notes/sIj75u8g1hGDT5pTqhhq1743159790.png\" width=\"500\"/>\n<ul>\n<li><strong>Mixed form: </strong>Exhibits characteristics of both the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> (palpebral) and <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> subtypes, typically presenting in only one eye.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Maxwell Lyon's sign</strong> is a <span class=\"customMeta\" data-dictid=\"a952f661da169277719691c48c8cbe\">pseudomembrane</span> formed due to excessive <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> deposition on the <span class=\"customMeta\" data-dictid=\"0a6b15e83616927771941190f46a83\">papilla</span> resulting in cobblestone papillae.</p>\n<p><img alt=\"Maxwell lyon sign\" data-author=\"Alexandre Xavier Costa, José Álvaro Pereira Gomes, Leonardo Guedes Candido Marculino, Vera Lucia Liendo, Telma Pereira Barreiro, Myrna Serapião dos Santos\" data-hash=\"4403\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Efficacy-of-supratarsal-triamcinolone-injection-after-1-week-on-the-upper-tarsal_fig1_318869687\" data-tags=\"March2025\" height=\"399\" src=\"https://image.prepladder.com/notes/Ex6h40HVqEAqfIkChJOJ1743159861.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Histology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>In the palpebral form, <strong>hypertrophied </strong>papillae are observed, rich in eosinophils and other <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p style=\"text-align: center;\"><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>Topical therapy:</strong>\n<ul>\n<li>Antihistamines - Levocabastine &amp; emedastine</li>\n<li>Mast cell stabilizers - Sodium cromoglicate</li>\n<li>Mild steroids - Fluorometholone and <span class=\"customMeta\" data-dictid=\"1ef009aee816927771912e72480697\">loteprednol</span> etabonate,</li>\n<li>Acetylcysteine can control <span class=\"customMeta\" data-dictid=\"7a1ae24f701692777187a7f60bbd9f\">excess</span> mucus.</li>\n</ul>\n</li>\n<li><strong>Local therapy</strong>: Subtarsal <span class=\"customMeta\" data-dictid=\"a48ce797cd1692777199efc43b3e4c\">steroid</span> injections and <span class=\"customMeta\" data-dictid=\"7a2baeba7416927771858fcddc798f\">cryotherapy</span> for severe cases.</li>\n<li><strong>Surgical treatment: </strong>Excision of giant <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> and treatment of <span class=\"customMeta\" data-dictid=\"018fabee35169277719835cd1bf49c\">shield</span> ulcers with debridement and <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> or <span class=\"customMeta\" data-dictid=\"4f62176420169277718214bfcafae5\">bandage</span> contact lens.</li>\n<li>Cold compresses and tinted <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> for comfort.</li>\n<li>Avoid eye rubbing</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/klkGcqOqysi5ZUlLq1CF1745224224.mp3", "video": ""}, {"text": "Which of the following statements is true regarding the epithelium of the conjunctiva?", "options": [{"label": "A", "text": "The epithelium of the limbal conjunctiva is thinner than that of the fornices.", "correct": false}, {"label": "B", "text": "The conjunctival epithelium is lined by stratified non-keratinized epithelium.", "correct": true}, {"label": "C", "text": "The adenoid layer of the conjunctiva is present at birth and plays a role in neonatal immunity.", "correct": false}, {"label": "D", "text": "The dense fibrous layer is superficial to the adenoid layer and contains goblet cells.", "correct": false}], "correct_answer": "B. The conjunctival epithelium is lined by stratified non-keratinized epithelium.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/G0StzoruMKx9hhtG8Zqi1743135770.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:683px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Layers of Conjunctiva</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Outer Epithelial Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lined by <span class=\"customMeta\" data-dictid=\"e2f163c4cd1692777199def45e74f1\">stratified</span> <span class=\"customMeta\" data-dictid=\"5be0ee4ea316927771997104326685\">squamous</span> epithelium. The <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> gradually thickens from the fornices to the limbus<strong>(Option A)</strong>, becoming <strong>stratified and nonkeratinized near the corneal margin</strong>, while the palpebral <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> <strong>lining the eyelids remains thinner and nonkeratinized</strong>. It contains:</p>\n<ul>\n<li>Goblet cells</li>\n<li>Melanocytes</li>\n<li>Langerhans cells</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adenoid Layer (or <span class=\"customMeta\" data-dictid=\"32599f889a169277719169e3483e62\">lymphoid</span> layer)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is located below the epithelium. This layer develops <span class=\"customMeta\" data-dictid=\"32599f889a169277719169e3483e62\">lymphoid</span> tissue only after 3-4 months of age, which explains why newborns cannot produce a <span class=\"customMeta\" data-dictid=\"031a38f17a16927772036476ede2ae\">follicular</span> conjunctival reaction.<strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dense <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">Fibrous</span> Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is present deep in the <span class=\"customMeta\" data-dictid=\"11fd4461491692777180591f35947b\">adenoid</span> layer, merging into the underlying tissues (lid or sclera). This layer contains the vessels and nerves of the conjunctiva.<strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Layers-of-conjunctiva\" data-author=\"NA\" data-hash=\"4233\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/G0StzoruMKx9hhtG8Zqi1743135770.png\" width=\"500\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/R22jpgjjC1rRtj2dOD071747295294.mp3", "video": ""}, {"text": "A patient with characteristic features of trachoma is being evaluated. Which of the following would be the most appropriate systemic antibiotic to be used for the treatment of trachoma?", "options": [{"label": "A", "text": "Erythromycin", "correct": false}, {"label": "B", "text": "Doxycycline", "correct": false}, {"label": "C", "text": "Amoxicillin", "correct": false}, {"label": "D", "text": "Azithromycin", "correct": true}], "correct_answer": "D. Azithromycin", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:726px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Investigations </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Micro-immunofluorescence (micro-IF): Using pooled antigens; For routine <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> purposes</li>\n<li>Culture of C. trachomatis: In irradiated McCoy cells; Expensive</li>\n<li>Monoclonal <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> direct tests: IgA-IPA light <span class=\"customMeta\" data-dictid=\"51df8cdfc91692777192aa76f4de51\">microscopy</span> tests are the best combination for diagnosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>SAFE </strong>is a WHO-recommended combination of interventions to treat <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">trachoma</span> and prevent it from leading to blindness</p>\n<ul>\n<li><strong>S</strong>urgery for <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">cicatricial</span> <span class=\"customMeta\" data-dictid=\"bcd6d163731692777187fccac22750\">entropion</span> and <span class=\"customMeta\" data-dictid=\"707ba8ae1b1692777200f19bfbcdba\">trichiasis</span> <strong>(Tertiary prevention)</strong></li>\n<li><strong>A</strong>ntibiotics to eliminate the organism <strong>(Secondary prevention)</strong></li>\n<li><strong>F</strong>acial cleanliness to avoid infection <strong>(Primary prevention)</strong></li>\n</ul>\n<ul>\n<li><strong>E</strong>nvironmental improvement with better <span class=\"customMeta\" data-dictid=\"15fa752a4f1692777189fe275abf3f\">hygiene</span> and <span class=\"customMeta\" data-dictid=\"18aafee1a71692777198cdc688e8aa\">sanitation</span> <strong>(Primordial prevention)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Environmental improvement (Primordial prevention)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Water latrines and good water supply to reduce flies</li>\n<li>Refuse dumps</li>\n<li>Sprays to control flies</li>\n<li>Animal pens away from houses</li>\n<li>Health education</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Facial cleanliness (Primary prevention)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Frequent face wash with clean water</li>\n<li>Avoid common towels, handkerchiefs, <span class=\"customMeta\" data-dictid=\"1f30aa8f821692777199c5995b237b\">Surma</span> rods, etc</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antibiotics (Secondary prevention)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Community-based mass <span class=\"customMeta\" data-dictid=\"ff6b4f4d491692777181a02bad075e\">antibiotic</span> therapy:</strong></p>\n<ul>\n<li><strong>For areas with 10% or more <span class=\"customMeta\" data-dictid=\"f86aae0bd61692777196f91458c9dd\">prevalence</span> of active <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">trachoma</span> (TF in children 1-9 yrs):</strong>\n<ul>\n<li>Azithromycin single oral dose 20 mg/kg to all community members <strong>OR</strong></li>\n<li>Tetracycline 1% eye <span class=\"customMeta\" data-dictid=\"25ee86538e1692777194ef5ba9e4f1\">ointment</span> BD for 6 weeks for all pregnant women, children, and those with allergies to macrolides.</li>\n<li>Continued till TF <span class=\"customMeta\" data-dictid=\"f86aae0bd61692777196f91458c9dd\">prevalence</span> in 1-9yrs becomes &lt;5%</li>\n</ul>\n</li>\n<li><strong>5% to 10% prevalence: </strong>Antibiotic therapy targeted in the family and close contact only</li>\n<li><strong>Less than 5% prevalence:</strong> Only patients are treated</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blanket therapy</strong> (Intermittent therapy):</p>\n<ul>\n<li><strong>Indication:</strong> &gt;5% <span class=\"customMeta\" data-dictid=\"f86aae0bd61692777196f91458c9dd\">prevalence</span> of severe and moderate <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">trachoma</span> in 1-9 yrs old.</li>\n<li>Application of<strong> 1% <span class=\"customMeta\" data-dictid=\"8784b5a7ad16927772005323b514b8\">tetracycline</span> ointment</strong> to all children:</li>\n</ul>\n<ul>\n<li>Twice daily (BD) for 5 consecutive days each month, for 6 months <strong>OR</strong></li>\n<li>Once daily (OD) for 10 consecutive days each month, for 6 months<strong> OR</strong></li>\n<li>For 60 consecutive days</li>\n</ul>\n<ul>\n<li>Alternative antibiotic: <strong>Erythromycin</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Surgery (Tertiary prevention)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Simple epilation</li>\n<li>Repair</li>\n<li>Bilamellar <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> rotation</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Z8r4RQQb7z2A3AlA2WPm1747300923.mp3", "video": ""}, {"text": "A patient presents with irritation of the eyes and foreign body sensation in the eyes. He is examined by the ophthalmologist, who observes the following in his upper eyelid. According to the WHO classification, which grade is the disease here?", "options": [{"label": "A", "text": "TF", "correct": false}, {"label": "B", "text": "TI", "correct": false}, {"label": "C", "text": "CO", "correct": false}, {"label": "D", "text": "TS", "correct": true}], "correct_answer": "D. TS", "question_images": ["https://image.prepladder.com/notes/UtU7HoCYH4W9Rpwgg2fh1747311268.png"], "explanation_images": ["https://image.prepladder.com/notes/QZMZ38fOVYIMthEZbVtD1743151543.png", "https://image.prepladder.com/notes/AbU0PbhU8iVS4k8ON1mi1743151623.png", "https://image.prepladder.com/notes/UtU7HoCYH4W9Rpwgg2fh1747311268.png", "https://image.prepladder.com/notes/Drgb6pJoDWWkFjZoLSp61743151769.png", "https://image.prepladder.com/notes/wHL4T2hyn6da0vjSgLwU1743151868.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:710px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>WHO Classification of <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">Trachoma</span> (FISTO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Management</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TF</strong>:</p>\n<p>Trachomatous Inflammation- <strong>Follicular </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The presence of five or more follicles in the upper <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva<strong> </strong></li>\n<li>Active stage of trachoma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Trachomatous inflammation 1\" data-author=\"Victor H Hu, Martin J Holland, Matthew J Burton\" data-hash=\"4357\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"March2025\" height=\"323\" src=\"https://image.prepladder.com/notes/QZMZ38fOVYIMthEZbVtD1743151543.png\" width=\"500\"/></td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Antibiotics to eliminate the organism</li>\n<li>Topical:\n\t\t\t\t<ul>\n<li>Tetracycline 1% or</li>\n<li>Erythromycin 1%</li>\n<li>Sulfacetamide</li>\n</ul>\n</li>\n<li>Systemic:\n\t\t\t\t<ul>\n<li>Tetracycline or <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> orally</li>\n<li>Doxycycline orally</li>\n<li>Azithromycin single oral dose</li>\n</ul>\n</li>\n<li>Combined <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> and <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> therapy:\n\t\t\t\t<ul>\n<li>For TI or when an associated <span class=\"customMeta\" data-dictid=\"0e919a208b16927771885d9c1f6662\">genital</span> infection is present</li>\n<li>Tetracycline 1% or <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> 1% eye ointment</li>\n<li>Azithromycin orally</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TI</strong>: Trachamatous Inflammation- <strong>Intense</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pronounced <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> thickening of the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> that obscures more than half of the normal deep <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> vessels.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP371-Trachomatous inflammation 2\" data-author=\"Victor H Hu, Martin J Holland, Matthew J Burton\" data-hash=\"4358\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"March2025\" height=\"331\" src=\"https://image.prepladder.com/notes/AbU0PbhU8iVS4k8ON1mi1743151623.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TS: </strong>Trachamatous <strong>Scarring </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Presence of <span class=\"customMeta\" data-dictid=\"e9dcc3d4241692777198c7030bf313\">scarring</span> in <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva</li>\n<li>White, bands or sheets of <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> in <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Arlt's line\" data-author=\"\" data-hash=\"12785\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"121\" src=\"https://image.prepladder.com/notes/UtU7HoCYH4W9Rpwgg2fh1747311268.png\" width=\"179\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Concretions removed with a <span class=\"customMeta\" data-dictid=\"e978bee5781692777189dddd001d74\">hypodermic</span> needle</li>\n<li>Conjunctival <span class=\"customMeta\" data-dictid=\"9a100e80c71692777202114329893c\">xerosis</span> with artificial <span class=\"customMeta\" data-dictid=\"1717bdb5d21692777200d45e31ceed\">tears</span> (lubricating drops)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TT: </strong>Trachamatous <strong>Trichiasis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>At least one <span class=\"customMeta\" data-dictid=\"5b4dd03e7d16927771877ac3787035\">eyelash</span> rub on <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> or evidence of recent removal of inturned eyelashes.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Trachomatous inflammation 4\" data-author=\"Victor H Hu, Martin J Holland, Matthew J Burton\" data-hash=\"4360\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"March2025\" height=\"326\" src=\"https://image.prepladder.com/notes/Drgb6pJoDWWkFjZoLSp61743151769.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Permanent lash removal</strong>:\n\t\t\t\t<ul>\n<li>Electrolysis</li>\n<li>Cryolysis</li>\n<li>Radiofrequency epilation</li>\n<li>Bilamellar <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> resection</li>\n</ul>\n</li>\n<li>Cicatricial <span class=\"customMeta\" data-dictid=\"bcd6d163731692777187fccac22750\">entropion</span> surgery</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CO: Corneal Opacity</strong> <strong> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Easily visible corneal <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> over the pupil</li>\n<li>Part of the <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> margin is blurred when seen through the <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> as it is very dense corneal scarring</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Trachomatous inflammation 5\" data-author=\"Victor H Hu, Martin J Holland, Matthew J Burton\" data-hash=\"4361\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"March2025\" height=\"326\" src=\"https://image.prepladder.com/notes/wHL4T2hyn6da0vjSgLwU1743151868.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>After treatment of other <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">trachoma</span> sequelae</li>\n<li><strong>Penetrating <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> </strong>for significant corneal scarring</li>\n<li><strong>Keratoprosthesis </strong>for <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> blind cases with extensive <span class=\"customMeta\" data-dictid=\"e9dcc3d4241692777198c7030bf313\">scarring</span> and surface problems</li>\n<li><strong>Punctal <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> </strong>and <strong>lateral <span class=\"customMeta\" data-dictid=\"9d7ef2a8991692777200bbed2388b0\">tarsorrhaphy</span> </strong>for coexistent eye surface problems</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/88eY2FqSf83JKuO2QCMx1747300097.mp3", "video": ""}, {"text": "An 8-year-old female is being evaluated for conjunctivitis. She gives a history of itching and mild foreign body sensation in the eyes, stickiness of the lids, and mucoid discharge from the eyes. On examination, there is conjunctival congestion. Which of the following signs would be seen in this stage of the disease?", "options": [{"label": "A", "text": "Pannus siccus", "correct": false}, {"label": "B", "text": "Arlt’s line", "correct": false}, {"label": "C", "text": "Herbert’s follicle", "correct": true}, {"label": "D", "text": "Tylosis", "correct": false}], "correct_answer": "C. Herbert’s follicle", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Hpeox3uJ4kxuZHbwQ02J1743139333.png", "https://image.prepladder.com/notes/IoP5q1K5eMtQDy07sTBu1743139425.png", "https://image.prepladder.com/notes/grHGvfNFmKmtSUTBTJcX1743139498.png", "https://image.prepladder.com/notes/bkIexoHxgDXsv8edbqf51743140055.png", "https://image.prepladder.com/notes/nKXxEVurd8XmHenptlu01743140246.png", "https://image.prepladder.com/notes/URHhab0eFjdGHllfi4CT1743139548.png", "https://image.prepladder.com/notes/j3oi8PBKeVl436Mi8tZy1743140325.png", "https://image.prepladder.com/notes/XvZFS4XjAFKvvkrpwuzK1743140386.png", "https://image.prepladder.com/notes/h5CvTxp6imJboiPIm5qt1743140451.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs of active trachoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs of <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">cicatricial</span> trachoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li>Conjunctival congestion</li>\n<li>Follicles in the upper <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva: Look like sago-grains</li>\n</ul>\n<ul>\n<li>Papillary enlargement: red, velvety</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li><strong>Scarring </strong>\n<ul>\n<li>It may be irregular, star-shaped, or linear</li>\n<li>Linear <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> in the <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> subtarsalis is called <strong>Arlt’s line </strong><strong>(Option B)</strong><strong> </strong></li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>accumulation of dead epithelial cells and <span class=\"customMeta\" data-dictid=\"11d92ee2d916927771907f5dfc40d1\">inspissated</span> <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> in the glands of Henle</li>\n<li>Pseudocyst</li>\n<li>Xerosis</li>\n<li>Symblepharon</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li>Superficial <span class=\"customMeta\" data-dictid=\"f1711947d41692777190ce56ef2f7d\">keratitis</span> on <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp and fluorescein</li>\n<li><strong>Herbert’s follicles</strong><strong> </strong></li>\n<li><strong>Progressive </strong>pannus/<strong>Trachomatous pannus</strong>: The <strong>upper part of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is cloudy</strong></li>\n</ul>\n<ul>\n<li><strong>Corneal ulcers </strong>are common at the advancing edge of the pannus\n\n\t\t\t\t<ul>\n<li>Shallow, little infiltrated</li>\n<li>Cause <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> and photophobia</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li><strong>Regressive </strong>pannus or <strong>pannus <span class=\"customMeta\" data-dictid=\"ea37ba98bc1692777198036920f1d6\">siccus</span> </strong><strong>(Option A)</strong>:\n\n\t\t\t\t<ul>\n<li>Receding infiltration</li>\n<li>Vessels extend beyond the area of <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> and haze</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Herbert pits</strong>: <span class=\"customMeta\" data-dictid=\"74793d564816927771943ae4ba74b3\">oval</span> or <span class=\"customMeta\" data-dictid=\"0919f0017e1692777184ac3748841f\">circular</span> pitted scars <strong>formed after the <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> of Herbert’s follicles in the <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> area</strong></li>\n</ul>\n<ul>\n<li>Vascularized and <strong>opaque cornea.</strong></li>\n<li>Corneal xerosis</li>\n<li>Corneal ectasia</li>\n<li>Total corneal <span class=\"customMeta\" data-dictid=\"388a4ccfbf1692777194a8f6a2d3b4\">pannus</span> (blinding sequelae)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lid signs:</strong></p>\n<ul>\n<li>Distortion of the lids</li>\n<li><strong>Tylosis </strong><strong>(Option D)</strong>: Thickening of the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> plate/lid margin</li>\n<li><strong>Trichiasis (Option C) </strong>due to <span class=\"customMeta\" data-dictid=\"97ae59957c1692777197359406f6f4\">rubbing</span> of lashes on the cornea</li>\n<li><strong>Trachomatous <span class=\"customMeta\" data-dictid=\"e18c2053271692777194e62a208e01\">ptosis</span> </strong>(sleepy appearance)</li>\n<li><strong>Entropion</strong></li>\n<li>Madarosis</li>\n<li>Ankyloblepharon</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lacrimal <span class=\"customMeta\" data-dictid=\"5a70fb96bf1692777181823f42fcf0\">apparatus</span> sequelae:</strong></p>\n<ul>\n<li>Chronic dacryocystitis</li>\n<li>Chronic dacryoadenitis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:789px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Active <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">Trachoma</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> \n\t\t\t<p>Follicles in upper palpebral conjunctiva</p>\n<p><img alt=\"Follicular-trachoma\" data-author=\"Diane K. Lavett, Van C Lansingh, Marissa J Carter, Kristen A Eckert, Juan Carlos Silva\" data-hash=\"4281\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Inflammatory-trachoma-with-Follicular-trachoma-TI-TF-stage-Figure-courtesy-of_fig6_237843559\" data-tags=\"March2025\" height=\"359\" src=\"https://image.prepladder.com/notes/Hpeox3uJ4kxuZHbwQ02J1743139333.png\" width=\"500\"/></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> \n\t\t\t<p>Trachomatous pannus</p>\n<p> </p>\n<p><img alt=\"pannus-with-Morgagnian-cataract-Trachoma\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"4286\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/Pannus-superior-limbus-with-Morgagnian-cataract.html#gsc.tab=0\" data-tags=\"March2025\" height=\"270\" src=\"https://image.prepladder.com/notes/IoP5q1K5eMtQDy07sTBu1743139425.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> \n\t\t\t<p>Progressive pannus</p>\n<p> </p>\n<p><img alt=\"Progressive pannus N\" data-author=\"NA\" data-hash=\"4287\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/grHGvfNFmKmtSUTBTJcX1743139498.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cicatricial </strong></p>\n<p><strong>Trachoma </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">Arlt's line<img alt=\"Arlts-line\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"4289\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"March2025\" height=\"246\" src=\"https://image.prepladder.com/notes/bkIexoHxgDXsv8edbqf51743140055.png\" width=\"500\"/></td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">Herbert's pits<img alt=\"Herberts-pits\" data-author=\"Justin Risma, MD ,Stefani Karakas, CRA\" data-hash=\"4290\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/herberts-pits.htm#gsc.tab=0\" data-tags=\"March2025\" height=\"239\" src=\"https://image.prepladder.com/notes/nKXxEVurd8XmHenptlu01743140246.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"> \n\t\t\t<p>Regressive pannus</p>\n<p> </p>\n<p> </p>\n<p><img alt=\"Regressive pannus\" data-author=\"NA\" data-hash=\"4288\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/URHhab0eFjdGHllfi4CT1743139548.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Conjunctival concretions\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"4291\" data-license=\"CC BY NC ND\" data-source=\"https://eyerounds.org/atlas/pages/nidus-of-tarsal-conjunctival-concretions-meibomian-infarct.html#gsc.tab=0\" data-tags=\"March2025\" height=\"462\" src=\"https://image.prepladder.com/notes/j3oi8PBKeVl436Mi8tZy1743140325.png\" width=\"500\"/>\n<p>Conjunctival concretions</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Trichiasis\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"4292\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"March2025\" height=\"329\" src=\"https://image.prepladder.com/notes/XvZFS4XjAFKvvkrpwuzK1743140386.png\" width=\"500\"/>\n<p>Trichiasis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\"><img alt=\"Tylosis\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"4293\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"March2025\" height=\"278\" src=\"https://image.prepladder.com/notes/h5CvTxp6imJboiPIm5qt1743140451.png\" width=\"500\"/>\n<p>Tylosis (thickening of <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> border of eyelid)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GeGQ0wPNmJkkw4TjgoJQ1747299576.mp3", "video": ""}, {"text": "A 28-year-old man develops sudden redness, Foreign body sensation and subconjunctival haemorrhage in both eyes after returning from a tropical region. His visual acuity is normal. What is the most likely causative agent?", "options": [{"label": "A", "text": "Epstein-Barr virus", "correct": false}, {"label": "B", "text": "Coxsackievirus", "correct": true}, {"label": "C", "text": "Herpes simplex virus", "correct": false}, {"label": "D", "text": "Molluscum Contagiosum", "correct": false}], "correct_answer": "B. Coxsackievirus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/FHQ0OxGBV2fQLjRBM4wK1743138487.png", "https://image.prepladder.com/notes/BTnjhtO7fc7U09A9QXTb1743138541.png", "https://image.prepladder.com/notes/VTZX5bDfYP5sQ1fDKBIZ1743138618.png", "https://image.prepladder.com/notes/RILMilK7QjhiKZq161L41743138804.png", "https://image.prepladder.com/notes/M5sj9HI6lK9vlmGnjl1N1743138887.png", "https://image.prepladder.com/notes/fe7GCbv5TvvXIA2hXsx41743138954.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:745px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Herpetic Conjunctivitis</strong><strong> </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hemorrhagic Conjunctivitis/ Apollo Conjunctivitis</strong><strong> </strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Molluscum Contagiosum</strong><strong> </strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Commonly caused by <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> simplex type 1.</li>\n<li>Seen in young children infected by <span class=\"customMeta\" data-dictid=\"b0e2b626661692777185baaa64d71f\">contagion</span> carriers of the virus.</li>\n<li>Corneal vesicles merge to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> <span class=\"customMeta\" data-dictid=\"77f797c5e8169277718535480fa7fd\">dendritic</span> figures.</li>\n<li><strong>Treatment: </strong>\n<ul>\n<li>Topical lubricants</li>\n<li>If corneal is involved: Acyclovir 3% or <span class=\"customMeta\" data-dictid=\"b1e06f9ba516927772026b7524b653\">vidarabine</span> 3% eye <span class=\"customMeta\" data-dictid=\"25ee86538e1692777194ef5ba9e4f1\">ointment</span> or <span class=\"customMeta\" data-dictid=\"e569d6f60f1692777200c5fd556060\">trifluorothymidine</span> 1% drops 5 times a day.</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Cause: </strong>\n<ul>\n<li>Coxsackievirus</li>\n<li>Enterovirus 70</li>\n</ul>\n</li>\n<li>Occurs in the <span class=\"customMeta\" data-dictid=\"703c39de691692777194908dd125e5\">pandemic</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of violent <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> conjunctivitis.</li>\n<li><strong>Clinical Features:</strong>\n<ul>\n<li>Lacrimation</li>\n<li>Photophobia</li>\n<li>Subconjunctival hemorrhage</li>\n<li>Enlarged <span class=\"customMeta\" data-dictid=\"27e48cf41316927771961349c8294d\">preauricular</span> <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> nodes</li>\n<li>Cornea is usually affected</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Caused by poxvirus.</li>\n<li>Small, white, <span class=\"customMeta\" data-dictid=\"8f8fd290fb169277720176f87fa1f5\">umbilicated</span> swelling, generally multiple.</li>\n<li>Produces severe <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> and occasionally keratitis.</li>\n<li><strong>Treatment: </strong>Surgical excision.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Dendritic corneal ulcer\" data-author=\"Imrankabirhossain\" data-hash=\"4267\" data-license=\"CC BY SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Dendritic_corneal_ulcer.jpg\" data-tags=\"March2025\" height=\"562\" src=\"https://image.prepladder.com/notes/RILMilK7QjhiKZq161L41743138804.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Acute_hemorrhagic_conjunctivitis\" data-author=\"James Heilman, MD\" data-hash=\"4270\" data-license=\"CC BY SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Acute_hemorrhagic_conjunctivitis.jpg\" data-tags=\"March2025\" height=\"185\" src=\"https://image.prepladder.com/notes/M5sj9HI6lK9vlmGnjl1N1743138887.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Molluscum contagiosum eye\" data-author=\"Şule Serin, Ayşe Bozkurt Oflaz, Pınar Karabağlı, Şansal Gedik, and Banu Bozkurt\" data-hash=\"4273\" data-license=\"CC BY\" data-source=\"https://europepmc.org/article/pmc/5563552\" data-tags=\"March2025\" height=\"347\" src=\"https://image.prepladder.com/notes/fe7GCbv5TvvXIA2hXsx41743138954.png\" width=\"500\"/></td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VeO32h5B4mwUOzmnDduT1747298558.mp3", "video": ""}, {"text": "A 30-year-old male presents with irritation and redness at both eye corners, foamy discharge, and skin maceration as shown below. He also has chronic nasal discharge. Which organism is most likely causing his symptoms?", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Moraxella axenfeld", "correct": true}, {"label": "C", "text": "Neisseria gonorrhoeae", "correct": false}, {"label": "D", "text": "Haemophilus influenzae", "correct": false}], "correct_answer": "B. Moraxella axenfeld", "question_images": ["https://image.prepladder.com/notes/R1nFBWorlp6nI6qpeAP61743138317.png"], "explanation_images": ["https://image.prepladder.com/notes/R1nFBWorlp6nI6qpeAP61743138317.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Angular <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">Conjunctivitis</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type of chronic <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> characterized by mild <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> confined to the <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> and lid margins near the angles of the eyes, associated with <span class=\"customMeta\" data-dictid=\"3258aabd771692777191b1b1f47be7\">maceration</span> of the surrounding skin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causative Agent</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Moraxella axenfeld is the most common cause, leading to the term \"diplobacillary conjunctivitis\" due to the <span class=\"customMeta\" data-dictid=\"fe0005a48b1692777182143f69e1d5\">bacilli</span> being arranged end-to-end.</li>\n<li>Rarely Staphylococci.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Source of Infection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nasal Cavity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mode of Transmission</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Infection is transmitted from the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> <span class=\"customMeta\" data-dictid=\"ddba4206eb169277718335596e86da\">cavity</span> to the eyes via contaminated fingers or handkerchiefs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"461ee544961692777182696a650b05\">bacillus</span> produces <span class=\"customMeta\" data-dictid=\"f8440ebdc11692777196443e066978\">proteolytic</span> enzymes that <span class=\"customMeta\" data-dictid=\"b0160b233f16927771918f88e0efcb\">macerate</span> the epithelium, resulting in mild <span class=\"customMeta\" data-dictid=\"e025d338b21692777184b4a309cbfb\">chronic inflammation</span> and <span class=\"customMeta\" data-dictid=\"6cc26a38ff1692777186dfa1267cfa\">eczematous</span> changes in the skin around the eye angles.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Irritation</li>\n<li>Burning sensation</li>\n<li>Discomfort in the eyes</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hyperemia of the <span class=\"customMeta\" data-dictid=\"ef00544aba1692777183bc916b1c30\">bulbar</span> <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> and lid margins near the angles</li>\n<li>Excoriation of the skin around the angles</li>\n<li>Foamy <span class=\"customMeta\" data-dictid=\"66d0cfdc741692777193d2b4fe3249\">mucopurulent</span> <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> at the angles</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"angular Conjunctivitis\" data-author=\"William Charles Caccamise\" data-hash=\"4251\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/angular-conjunctivitis.html#gsc.tab=0\" data-tags=\"March2025\" height=\"306\" src=\"https://image.prepladder.com/notes/R1nFBWorlp6nI6qpeAP61743138317.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Blepharitis</li>\n<li>Shallow marginal catarrhal corneal ulceration</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Oxytetracycline (1%) eye <span class=\"customMeta\" data-dictid=\"25ee86538e1692777194ef5ba9e4f1\">ointment</span> </strong>applied 2-3 times a day for 9-14 days.</li>\n<li><strong>Zinc lotion</strong> instilled during the day, and <span class=\"customMeta\" data-dictid=\"39ecb6e07416927772029550b7e74a\">zinc</span> <span class=\"customMeta\" data-dictid=\"e08c004e8f1692777194c9d37e17ad\">oxide</span> <span class=\"customMeta\" data-dictid=\"25ee86538e1692777194ef5ba9e4f1\">ointment</span> at bedtime to <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">inhibit</span> the <span class=\"customMeta\" data-dictid=\"f8440ebdc11692777196443e066978\">proteolytic</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> and reduce maceration.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xtjE2NNJfsNF6rCnHPku1747297965.mp3", "video": ""}, {"text": "A 7-year-old child presents with the eye condition shown in the image. The child reports severe eye pain, redness, and eyelid swelling. Examination reveals an inflamed conjunctiva with thick, adherent membranes that bleed when removed. Which of the following organisms is most likely responsible for this presentation?", "options": [{"label": "A", "text": "Adenovirus", "correct": false}, {"label": "B", "text": "Neisseria gonorrhoeae", "correct": false}, {"label": "C", "text": "Corynebacterium diphtheria", "correct": true}, {"label": "D", "text": "Beta-hemolytic streptococci", "correct": false}], "correct_answer": "C. Corynebacterium diphtheria", "question_images": ["https://image.prepladder.com/notes/HtWiu4FkGXA1LJnfuGQH1743137837.png"], "explanation_images": ["https://image.prepladder.com/notes/HtWiu4FkGXA1LJnfuGQH1743137837.png", "https://image.prepladder.com/notes/BRt5nMKnern3vWTQOeln1743137952.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:633px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Membranous Conjunctivitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pseudomembranous Conjunctivitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>True membranes grow into the conjunctival <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> and are more adherent.</li>\n<li>Removal of these membranes often results in significant bleeding.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>More superficial, with no growth into conjunctival epithelium, and are less adherent than true membranes.</li>\n<li>These can be removed with minimal bleeding.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Bacterial: </strong>Corynebacterium diphtheria.</li>\n<li><strong>Drug Reactions</strong>: Hypersensitivity reactions, Stevens-Johnson syndrome (SJS).</li>\n<li><strong>Chemical or <span class=\"customMeta\" data-dictid=\"e316517c941692777200eb2671128d\">thermal</span> injury</strong>.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Infectious</strong>: Mild Corynebacterium <span class=\"customMeta\" data-dictid=\"233cc736b01692777186a2a5ac98f1\">diphtheria</span> infection, Neisseria gonorrhoeae <strong>(Option B ruled out)</strong>, Streptococcus pyogenes <strong>(Option D ruled out)</strong>, Staphylococcus aureus, <span class=\"customMeta\" data-dictid=\"a122cc5a281692777180084ac1edd5\">adenovirus</span> <strong>(Option A ruled out)</strong>, COVID-19.</li>\n<li><strong>Inflammatory: </strong>Hypersensitivity reactions, foreign body reactions.</li>\n<li><strong>Ligneous Conjunctivitis</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Membranous_conjunctivitis\" data-author=\"Imrankabirhossain\" data-hash=\"4247\" data-license=\"CC BY SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Membranous_conjunctivitis.jpg\" data-tags=\"March2025\" height=\"445\" src=\"https://image.prepladder.com/notes/HtWiu4FkGXA1LJnfuGQH1743137837.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"pseudomembranous conjunctivitis\" data-author=\"Maria Jesus Lopez-Prats, Empar Sanz Marco, Juan Jose Hidalgo-Mora, Salvador Garcia-Delpech, Manuel Diaz-Llopis\" data-hash=\"4248\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Inflammatory-pseudomembranes-characteristic-of-viral-conjunctivitis_fig1_47676741\" data-tags=\"March2025\" height=\"296\" src=\"https://image.prepladder.com/notes/BRt5nMKnern3vWTQOeln1743137952.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Eye redness</li>\n<li>Eyelid swelling</li>\n<li>Watery discharge</li>\n<li>Visual disturbances</li>\n<li>Foreign body sensation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Conjunctival hyperemia</li>\n<li>Chemosis</li>\n<li>Eyelid edema</li>\n<li>Corneal edema</li>\n<li>Mucopurulent discharge</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Topical steroids and antibiotics.</li>\n<li>Lubricants improve comfort and rehydrate the eye.</li>\n<li>Membranes can dissolve on their own.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Peeling of pseudomembrane.</li>\n<li>Topical steroids and antibiotics.</li>\n<li>Removal of foreign bodies if present.</li>\n<li>Washing the <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> surface to remove chemical irritants.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bOmhDRzfeFXQHlvWvXzh1747236784.mp3", "video": ""}, {"text": "A 7-year-old presents with severe eye pain, intense redness, and copious purulent discharge from his right eye. He also has significant lid swelling and tender preauricular lymphadenopathy. Gram stain of the purulent discharge reveals Gram-negative intracellular diplococci. What is the next best step in management?", "options": [{"label": "A", "text": "Intravenous ampicillin", "correct": false}, {"label": "B", "text": "Eye irrigation with saline", "correct": false}, {"label": "C", "text": "Intramuscular Ceftriaxone", "correct": true}, {"label": "D", "text": "Topical antibiotic drops", "correct": false}], "correct_answer": "C. Intramuscular Ceftriaxone", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/QaC126DU2fcYWPrFqPkj1743137108.png", "https://image.prepladder.com/notes/OMzG3j1KHx24DdItp66D1743137176.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0m7lhIGvVV9S9ZReVuH71747297595.mp3", "video": ""}, {"text": "A 25-year-old woman with a history of soft contact lens use for the past 8 months presents with bilateral itching, redness, and watery discharge. Examination shows large, polygonal papillae on the upper tarsal conjunctiva. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Vernal Keratoconjunctivitis", "correct": false}, {"label": "B", "text": "Giant Papillary Conjunctivitis", "correct": true}, {"label": "C", "text": "Phlyctenular Conjunctivitis", "correct": false}, {"label": "D", "text": "Papillary Conjunctivitis", "correct": false}], "correct_answer": "B. Giant Papillary Conjunctivitis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Giant <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">Papillary</span> Conjunctivitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Specific allergic <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> affecting the superior <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Soft <span class=\"customMeta\" data-dictid=\"db283047011692777189a869dbce07\">hydrophilic</span> contact lenses</li>\n<li>Protruding <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> ends</li>\n<li>Ocular prostheses</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Underlying Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypersensitivity reactions (types I and IV)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Itching</li>\n<li>Watering</li>\n<li>Foreign body sensation</li>\n<li>Occasionally blurred vision</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Conjunctival <span class=\"customMeta\" data-dictid=\"2dd9736fdf16927771849f5a925f7d\">congestion</span> predominantly in the upper palpebral region</li>\n<li>Large polygonal <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> on superior <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva</li>\n<li>Macropapillae (0.3-1.0 mm) and giant <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> (1-2 mm)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Discontinue soft contact lenses, remove offending sutures, clean and polish <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> prosthesis; replace with <span class=\"customMeta\" data-dictid=\"ed1050ab241692777183d28df9ecad\">biocompatible</span> material (e.g., Biocoat).</li>\n<li>Ancillary therapy: <span class=\"customMeta\" data-dictid=\"1f95a52091169277719133cc234fe0\">Mast</span> cell stabilizers (e.g., lodoxamide, <span class=\"customMeta\" data-dictid=\"d3f7cd4f92169277718588c69a0f10\">cromolyn</span> sodium, olopatadine) along with artificial tears, <span class=\"customMeta\" data-dictid=\"4b296ae29b16927771815960a008db\">antihistaminic</span> drops, and decongestants.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"Gaint &lt;span class=\" custommeta\"=\"\" data-dictid=\"62b9af909d1692777194cd004f10f4\"/>papillary conjunctivitis\" data-author=\"Mpopi Lenake &amp; Nagib du Toit\" data-hash=\"4244\" data-license=\"CC BY-NC-ND 4.0\" data-source=\"https://www.tandfonline.com/doi/figure/10.1080/20786190.2014.977017?scroll=top&amp;needAccess=true\" data-tags=\"March2025\" height=\"353\" src=\"https://image.prepladder.com/notes/xqINweIHQcEvsqTa1n2k1743136949.png\" width=\"500\" /&gt;</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1nrDMzaYrUDVTUWNz3Ni1747297014.mp3", "video": ""}, {"text": "A 28-year-old woman reports bilateral itching, redness, and watery discharge that worsens in spring. Examination revealed mild conjunctival congestion with small papillae on the upper tarsal conjunctiva. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Viral Conjunctivitis", "correct": false}, {"label": "B", "text": "Allergic Conjunctivitis", "correct": true}, {"label": "C", "text": "Bacterial Conjunctivitis", "correct": false}, {"label": "D", "text": "Chlamydial Conjunctivitis", "correct": false}], "correct_answer": "B. Allergic Conjunctivitis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/08EuFAxC9wvBkolcEYKD1743136708.png", "https://image.prepladder.com/notes/xv4ENOX8KTyqlMlvoDPb1743136795.png", "https://image.prepladder.com/notes/WlYc1VYVGSwBD7MnaRAT1743136857.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Follicles</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Papillae </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Granuloma </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Yellowish-white, round elevations, 1-2 mm in diameter, due to <span class=\"customMeta\" data-dictid=\"c605d4126116927771916c2002638e\">lymphocyte</span> aggregations in the <span class=\"customMeta\" data-dictid=\"94aff4fd141692777199a78b5ed2eb\">subepithelial</span> <span class=\"customMeta\" data-dictid=\"11fd4461491692777180591f35947b\">adenoid</span> layer.</li>\n<li>Conjunctiva of newborns cannot produce follicles until 2-3 months of age.</li>\n</ul>\n<p><img alt=\"follicular-conjunctivitis\" data-author=\"Jesse Vislisel, MD\" data-hash=\"4241\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/follicular-conjunctivitis/index.htm#gsc.tab=0\" data-tags=\"March2025\" height=\"255\" src=\"https://image.prepladder.com/notes/08EuFAxC9wvBkolcEYKD1743136708.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hyperplasia of the normal <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> system with glomerulus-like bunches of capillaries growing into the epithelium.</li>\n</ul>\n<p><img alt=\"Conjunctival papillae\" data-author=\"Josephine Christy, Shivananda Narayana, Fredrick Mouttapa\" data-hash=\"4242\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/The-right-eye-showing-giant-papillae-in-the-upper-tarsal-conjunctiva-with-nonhealing_fig1_350688366\" data-tags=\"March2025\" height=\"377\" src=\"https://image.prepladder.com/notes/xv4ENOX8KTyqlMlvoDPb1743136795.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fleshy, sessile, or <span class=\"customMeta\" data-dictid=\"164f4942281692777195e900724cc3\">pedunculated</span> lesions with <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> tissue.</li>\n<li>May or may not be truly granulomatous.</li>\n<li>Resulting from chronic local irritation, such as foreign bodies.</li>\n</ul>\n<p><img alt=\"Conjunctival Granuloma\" data-author=\"Ignacio Domínguez, Cristián Cartes, Pablo Sabat, Oscar Ortiz, Gonzalo Matus, Leonidas Traipe\" data-hash=\"4243\" data-license=\"CC BY-NC-ND\" data-source=\"https://www.researchgate.net/publication/331309185_Isolated_conjunctival_granuloma_as_a_first_manifestation_of_Parinaud's_oculoglandular_syndrome_A_case_report\" data-tags=\"March2025\" height=\"380\" src=\"https://image.prepladder.com/notes/WlYc1VYVGSwBD7MnaRAT1743136857.png\" width=\"500\"/></p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacterial </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Viral </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Allergic </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chlamydial </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Congestion </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marked</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild to moderate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Papillae </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>±</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li> </li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>++</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>±</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Follicles</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>++</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Discharge </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Purulent or mucopurulent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Watery</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ropy/ watery</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mucopurulent</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:569px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Discharge </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Papillary Reaction </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Follicular Reaction</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mucopurulent </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B</strong>acterial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong>hlamydial</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Watery </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A</strong>llergic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>V</strong>iral</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Dre7HrL0Axr3QkdSjYTR1747379953.mp3", "video": ""}, {"text": "A 27-year-old male presents with redness, mild swelling, and foreign body sensation in the right eye for 2 days. On examination, no visual impairment is noted, and a diagnosis of acute conjunctivitis is made. Which of the following is not a common sign of conjunctivitis?", "options": [{"label": "A", "text": "No options available", "correct": false}], "correct_answer": "Unknown", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/tfclDxThR0lKGHHaOBl01743136156.png", "https://image.prepladder.com/notes/wR3Zv5GV7HyhkDJlVTly1747309857.png", "https://image.prepladder.com/notes/tfclDxThR0lKGHHaOBl01743136156.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:662px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjunctival Congestion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ciliary Congestion</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location of Congestion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Confined to the conjunctiva, often more marked in the fornices.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Involves the area around the corneal margin, known as the <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> region.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>On moving conjunctiva</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Congested vessels also move</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Congested vessels do not move</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacterial conjunctivitis, allergic conjunctivitis, <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> conjunctivitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute iridocyclitis, <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> glaucoma, keratitis, corneal ulcer.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Congestion\" data-author=\"\" data-hash=\"12783\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/wR3Zv5GV7HyhkDJlVTly1747309857.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Ciliary Congestion\" data-author=\"The McGraw Hill Companies, Inc.\" data-hash=\"4240\" data-license=\"NA\" data-source=\"https://doctorlib.org/medical/tintinalli-emergency-medicine/151.html\" data-tags=\"March2025\" height=\"284\" src=\"https://image.prepladder.com/notes/tfclDxThR0lKGHHaOBl01743136156.png\" width=\"500\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MXZi4jA3URAbbKwOywrv1747379475.mp3", "video": ""}, {"text": "Which of the following glands are primarily responsible for secreting mucus to maintain ocular surface moisture?", "options": [{"label": "A", "text": "Glands of Krause", "correct": false}, {"label": "B", "text": "Glands of Moll", "correct": true}, {"label": "C", "text": "Glands of Wolfring", "correct": false}, {"label": "D", "text": "Crypts of Moll", "correct": false}], "correct_answer": "B. Glands of Moll", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/hkvDqFergXt2QuLjgKm41743135849.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gland Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mucous Secretory Glands</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Goblet Cells</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Within the epithelial layer of the conjunctiva</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Crypts of Henle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tarsal conjunctiva</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glands of Manz</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limbal conjunctiva</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Accessory Lacrimal Glands</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glands of Krause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>In the <span class=\"customMeta\" data-dictid=\"335f16a33c16927771992f5c55bc4d\">subconjunctival</span> <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissue of fornices; 42 in the upper fornix, 8 in the lower fornix</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glands of Wolfring </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Upper border of the superior <span class=\"customMeta\" data-dictid=\"f7352fd2a916927772008dd529358e\">tarsus</span> and lower borders of the <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> tarsus</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glands of the Eyelid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Meibomian Glands</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stroma of the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> plate, lid margin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glands of Zeis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Along hair follicles of eyelashes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glands of Moll</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Near hair follicles of eyelashes</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vnBRy5m0LOF6SvM4rCdc1747296195.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 34 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient presents to the outpatient department with the following findings. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pterygium", "correct": false}, {"label": "B", "text": "Limbal dermoid", "correct": true}, {"label": "C", "text": "Pyogenic granuloma", "correct": false}, {"label": "D", "text": "Pinguecula", "correct": false}], "correct_answer": "B. Limbal dermoid", "question_images": ["https://image.prepladder.com/content/HpFBtLMd2PHTWKsqsO7B1724832934.png"], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\"&gt;Limbal&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a patient who has had contact with a COVID-19 patient, presenting with symptoms such as redness, sensitivity to light, excessive tearing, and overall discomfort, a thorough examination was conducted with no eye abnormality. Based on this information, which specific part of the eye is most likely to be affected in this patient?", "options": [{"label": "A", "text": "Conjunctiva", "correct": true}, {"label": "B", "text": "Uvea", "correct": false}, {"label": "C", "text": "Choroid", "correct": false}, {"label": "D", "text": "Retina", "correct": false}], "correct_answer": "A. Conjunctiva", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Conjunctiv\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 20-year-old male presents with fever and swelling of the left eyelid for the past two days. He has no history of trauma but experienced a mild flu-like illness one week ago. On examination, there is no chemosis or protrusion of the eyeball. Based on these observations, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Orbital cellulitis", "correct": false}, {"label": "B", "text": "Preseptal cellulitis", "correct": true}, {"label": "C", "text": "Panophthalmitis", "correct": false}, {"label": "D", "text": "Lid tumour", "correct": false}], "correct_answer": "B. Preseptal cellulitis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ifHCRf4va3WRgVvLXnxP1746703783.png"], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"788578009c1692777196a0a397bdc4\"&gt;Preseptal&lt;/span&gt; cellulitis</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Chandler’s Classification of <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">Orbital</span> Cellulitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>I - <span class=\"customMeta\" data-dictid=\"788578009c1692777196a0a397bdc4\">Preseptal</span> cellulitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Infection confined to the eyelid</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Eyelid swelling, no <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> involvement</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>II - <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">Orbital</span> <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Infection spreads to the orbit</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pain with eye movement, restricted mobility, no <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> formation, <span class=\"customMeta\" data-dictid=\"13976f70431692777184676bb77924\">chemosis</span> or proptosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>III - Subperiosteal abscess</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pus collection beneath periosteum</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Localized pus, proptosis, pain on movement, swelling</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>IV - <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">Orbital</span> abscess</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pus collection within the <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> tissues</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Severe proptosis, potential vision loss, risk of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve damage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>V - <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">Cavernous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Spread of infection to the <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> sinus</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral eye involvement, headache, <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve palsies</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which statement below does not accurately describe the clinical condition mentioned?", "options": [{"label": "A", "text": "Abnormal activity of p53 is seen in the pterygium tissue", "correct": false}, {"label": "B", "text": "Decreased activity of tissue inhibitors of metalloproteinases is seen", "correct": false}, {"label": "C", "text": "Destruction of Bowman’s layer occurs when the pterygium invades the cornea", "correct": true}, {"label": "D", "text": "Elastotic degeneration and hyalinization of the connective tissue of the conjunctivaoccur.", "correct": false}], "correct_answer": "C. Destruction of Bowman’s layer occurs when the pterygium invades the cornea", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Destruction of Bowman’s layer occurs when the &lt;span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\"&gt;pterygium&lt;/span&gt; invades th\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A contact lens user presents with the following clinical picture. He has had watering, redness, and foreign body sensation in the eye for the past 2 months. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Follicular conjunctivitis", "correct": false}, {"label": "B", "text": "Spring catarrh", "correct": false}, {"label": "C", "text": "Giant papillary conjunctivitis", "correct": true}, {"label": "D", "text": "Trachoma", "correct": false}], "correct_answer": "C. Giant papillary conjunctivitis", "question_images": ["https://image.prepladder.com/notes/p0WMGohHylCS9mBDLea11746441774.png"], "explanation_images": ["https://image.prepladder.com/content/NYz2JCcKlx9f4sqKHYTJ1745410026.png", "https://image.prepladder.com/content/62AHBz0SIU2ewYtzOG6q1745410035.png", "https://image.prepladder.com/content/CrUa6zUrkQ78xARZfKGp1745410044.png", "https://image.prepladder.com/content/qdvr6m4OzvWeTA6QtZZX1745410058.png"], "explanation": "<p>Correct Answer C - Giant &lt;span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\"&gt;papillary&lt;/span&gt; conjunctivitis</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Specific allergic <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> affecting the superior <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Soft <span class=\"customMeta\" data-dictid=\"db283047011692777189a869dbce07\">hydrophilic</span> <strong>contact lenses</strong></li>\n<li>Protruding <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> ends</li>\n<li>Ocular prostheses</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Underlying Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypersensitivity reactions <strong>(types I and IV)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Itching/ Watering</li>\n<li>Foreign body sensation</li>\n<li>Occasionally blurred vision</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Conjunctival <span class=\"customMeta\" data-dictid=\"2dd9736fdf16927771849f5a925f7d\">congestion</span> predominantly in the upper palpebral region</li>\n<li>Large polygonal <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> on superior <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva</li>\n<li>Macropapillae (0.3-1.0 mm) and giant <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> (1-2 mm)</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Ono, Santa &amp; Abelson, Mark.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Four-types-of-ocular-allergy_fig1_8092872\" data-tags=\"\" height=\"320\" src=\"https://image.prepladder.com/content/NYz2JCcKlx9f4sqKHYTJ1745410026.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Discontinue soft contact lenses, remove offending sutures, clean and polish <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> prosthesis; replace with <span class=\"customMeta\" data-dictid=\"ed1050ab241692777183d28df9ecad\">biocompatible</span> material (e.g., Biocoat).</li>\n<li>Ancillary therapy: Mast cell stabilizers (e.g., lodoxamide, <span class=\"customMeta\" data-dictid=\"d3f7cd4f92169277718588c69a0f10\">cromolyn</span> sodium, olopatadine) along with artificial tears, <span class=\"customMeta\" data-dictid=\"4b296ae29b16927771815960a008db\">antihistaminic</span> drops, and decongestants.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most frequently observed eye symptom of COVID-19?", "options": [{"label": "A", "text": "Retinal vein thrombosis", "correct": false}, {"label": "B", "text": "Viral keratouveitis", "correct": false}, {"label": "C", "text": "Follicular conjunctivitis", "correct": true}, {"label": "D", "text": "Pseudomembranous conjunctivitis", "correct": false}], "correct_answer": "C. Follicular conjunctivitis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjunctiva</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Follicular <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> (Most common)</strong></li>\n<li>Hemorrhagic conjunctivitis</li>\n<li>Pseudomembrane conjunctivitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sclera</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Scleritis/ Episcleritis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior chamber</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Anterior Uveitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior segment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> neuroretinopathy</li>\n<li>Purtscher-like retinopathy</li>\n<li>Retinal arterial/venous <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> (central/branched)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Optic neuritis, <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc edema</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Orbit</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sinusitis, Preseptal/Orbital cellulitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lacrimal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Epiphora</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Newborns</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Periorbital <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> (Most common manifestation in newborns)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following treatment options is most frequently used for recurrent pterygium?", "options": [{"label": "A", "text": "Conjunctival autograft", "correct": true}, {"label": "B", "text": "Beta-radiation", "correct": false}, {"label": "C", "text": "Observation", "correct": false}, {"label": "D", "text": "Bare sclera technique", "correct": false}], "correct_answer": "A. Conjunctival autograft", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:692px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Reassurance/Observation:</strong> if not causing any visual problems <strong>(Option C)</strong></p>\n<p><strong>Medical treatment: </strong></p>\n<ul>\n<li>Tear substitutes for small <span class=\"customMeta\" data-dictid=\"531cf746021692777197c135fbce82\">regressive</span> <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> with dry eye</li>\n<li>Topical steroids for associated inflammation</li>\n<li>Protection from UV rays with sunglasses</li>\n</ul>\n<p><strong>Surgical <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> for:</strong></p>\n<ul>\n<li>Progression of <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> towards the pupillary area causing excessive <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> and visual impairment</li>\n<li>Restricted <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> movements</li>\n<li>Disfiguring</li>\n<li>Diplopia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Procedures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Bare <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> technique: (Option D)</strong>\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> is excised from the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and conjunctiva, leaving a bare sclera</li>\n<li>Associated with a <strong>high <span class=\"customMeta\" data-dictid=\"1d849ebc9b1692777197d4af1fa8d2\">recurrence</span> rate</strong></li>\n</ul>\n</li>\n<li><strong>Autoconjunctival graft: (Option A)</strong>\n<ul>\n<li>A piece of <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> conjunctival tissue from <strong>the same or the other eye </strong>or An<strong> <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> <span class=\"customMeta\" data-dictid=\"a283380a9a1692777188549537a964\">graft</span> </strong>is used to cover the bare sclera</li>\n<li>Sutured at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> to cover the defect</li>\n<li>Less <span class=\"customMeta\" data-dictid=\"1d849ebc9b1692777197d4af1fa8d2\">recurrence</span> rate</li>\n</ul>\n</li>\n<li>Surgical <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> with <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> <span class=\"customMeta\" data-dictid=\"8a6b591d1d16927771900a3c620d92\">keratectomy</span> and <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> for deeply infiltrating <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> recalcitrant pterygia</li>\n<li>Old methods (not used now):\n\t\t\t\t<ul>\n<li>McRaynold’s operation</li>\n<li>Postoperative use of <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> irradiations</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Post-operative therapy and care</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prevent recurrence:\n\t\t\t\t<ul>\n<li><strong>Mitomycin C 0.02% drops </strong></li>\n<li>Complications like scleral necrosis, cataracts, and <span class=\"customMeta\" data-dictid=\"0b673ec1e31692777190e88b9898af\">iritis</span> <strong> </strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the most likely diagnosis for a 5-year-old boy presenting with severe itching, sensitivity to light, and sticky discharge from his eyes. Upon examination the following findings were seen?", "options": [{"label": "A", "text": "Trachoma", "correct": false}, {"label": "B", "text": "Vernal keratoconjunctivitis", "correct": true}, {"label": "C", "text": "Phlyctenular conjunctivitis", "correct": false}, {"label": "D", "text": "Xerophthalmia", "correct": false}], "correct_answer": "B. Vernal keratoconjunctivitis", "question_images": ["https://image.prepladder.com/content/OmKJLb5QGkj1j6f3k00I1746096747.png"], "explanation_images": ["https://image.prepladder.com/content/otPlf3cqIFEJfpP1Gabo1746096884.png", "https://image.prepladder.com/content/lQD9kjl93spM0gD5dRVD1747905701.png", "https://image.prepladder.com/content/B7d14GFPOTralGYrE9lT1746096884.png", "https://image.prepladder.com/content/BqMMZvcqzX1WIL2JchBK1746096884.png", "https://image.prepladder.com/content/Fp7w176wIXnUrZ6HqNxg1746096884.png", "https://image.prepladder.com/content/ZCYrlTsBu9ex7yJLvKBD1746096884.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:596px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<ul>\n<li>It is a <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> that tends to occur with the onset of warm weather. It primarily affects young children and adolescents, particularly boys.</li>\n<li><strong>Type I &amp; IV HSR reaction &gt; Type IV HSR</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Course </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>The condition typically starts in childhood and may resolve on its own over 5–10 years.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Burning, Itching, Photophobia (sensitivity to light), and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> (excessive tearing).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Palpebral Form: Hypertrophied palpebral <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> with a <strong>cobblestone appearance</strong>; bluish-white color; dense <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> tissue with thickened epithelium.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Addis H, Jeng BH\" data-hash=\"\" data-license=\"CC BY NC\" data-source=\"https://www.dovepress.com/vernal-keratoconjunctivitis-peer-reviewed-fulltext-article-OPTH\" data-tags=\"\" height=\"290\" src=\"https://image.prepladder.com/content/otPlf3cqIFEJfpP1Gabo1746096884.png\" width=\"399\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Limbal or Bulbar Form: Opacification at the limbus, <span class=\"customMeta\" data-dictid=\"be6fe9c6c316927771889dbaaf2b89\">gelatinous</span> thickening, and <strong>Horner–Trantas dots</strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jodhbir Singh Mehta, Wei-Li Chen, Arthur C. K. Cheng, Le Xuan Cung, Ivo J. Dualan, Ramesh Kekunnaya, Nurliza Khaliddin, Tae-Im Kim, Douglas K. Lam, Seo Wei Leo, Florence Manurung, Nattaporn Tesavibul, Dominique Bremond-Gignac\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Horner-Trantas-dots-Peri-limbal-Horner-Trantas-dots-are-focal-white-dots-consisting-of_fig5_362403730\" data-tags=\"\" height=\"193\" src=\"https://image.prepladder.com/content/lQD9kjl93spM0gD5dRVD1747905701.png\" width=\"880\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p><strong>Pseudogerontoxon/cupid’s bow </strong>(which resembles <span class=\"customMeta\" data-dictid=\"e11c93da8d1692777182758f2163d6\">arcus</span> senilis) is a grayish-white ring at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> seen in severe <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> <span class=\"customMeta\" data-dictid=\"b2a2e3ba5c1692777201528ac05837\">vernal</span> <span class=\"customMeta\" data-dictid=\"8b4e6e36bb169277719032f22681c2\">keratoconjunctivitis</span> (VKC).</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Seyfettin Erdem\" data-hash=\"\" data-license=\"CC BY NC 4.0\" data-source=\"https://www.researchgate.net/figure/Limbal-type-VKC-pseudogerontoxone-image-palpebral-papilla-64-patients-447-limbal_fig3_336972956\" data-tags=\"\" height=\"271\" src=\"https://image.prepladder.com/content/B7d14GFPOTralGYrE9lT1746096884.png\" width=\"456\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Shield ulcers</strong> are a significant <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> of VKC, particularly in severe cases. These microerosions typically <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> on the upper third of the cornea.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Yusuke Matsuzaki, Hiroshi Toshida, Toshihiko Ohta, Akira Murakami\" data-hash=\"\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Slitlamp-microscopic-image-of-a-25-year-old-man-showing-corneal-shield-ulcer-at-40-days_fig1_236941145\" data-tags=\"\" height=\"359\" src=\"https://image.prepladder.com/content/BqMMZvcqzX1WIL2JchBK1746096884.png\" width=\"470\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Mixed form: Exhibits characteristics of both the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> (palpebral) and <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> subtypes, typically presenting in only one eye.</li>\n<li><strong>Maxwell Lyon's sign</strong> is a <span class=\"customMeta\" data-dictid=\"a952f661da169277719691c48c8cbe\">pseudomembrane</span> formed due to excessive <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> deposition on the <span class=\"customMeta\" data-dictid=\"0a6b15e83616927771941190f46a83\">papilla</span> resulting in cobblestone papillae.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Alexandre Xavier Costa, José Álvaro Pereira Gomes, Leonardo Guedes Candido Marculino, Vera Lucia Liendo, Telma Pereira Barreiro, Myrna Serapião dos Santos\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Efficacy-of-supratarsal-triamcinolone-injection-after-1-week-on-the-upper-tarsal_fig1_318869687\" data-tags=\"\" height=\"291\" src=\"https://image.prepladder.com/content/Fp7w176wIXnUrZ6HqNxg1746096884.png\" width=\"364\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Histology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>In the palpebral form, hypertrophied <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> are observed, rich in eosinophils and other <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Topical therapy: </strong>\n<ul>\n<li>Antihistamines - Levocabastine &amp; emedastine</li>\n<li>Mast cell stabilizers - Sodium cromoglicate</li>\n<li>Mild steroids - Fluorometholone and <span class=\"customMeta\" data-dictid=\"1ef009aee816927771912e72480697\">loteprednol</span> etabonate,</li>\n<li>Acetylcysteine can control <span class=\"customMeta\" data-dictid=\"7a1ae24f701692777187a7f60bbd9f\">excess</span> mucus.</li>\n</ul>\n</li>\n<li>Local therapy: Subtarsal <span class=\"customMeta\" data-dictid=\"a48ce797cd1692777199efc43b3e4c\">steroid</span> injections and <span class=\"customMeta\" data-dictid=\"7a2baeba7416927771858fcddc798f\">cryotherapy</span> for severe cases.</li>\n<li>Surgical treatment: Excision of giant <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> and treatment of <span class=\"customMeta\" data-dictid=\"018fabee35169277719835cd1bf49c\">shield</span> ulcers with debridement and <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> or <span class=\"customMeta\" data-dictid=\"4f62176420169277718214bfcafae5\">bandage</span> contact lens.</li>\n<li>Cold compresses and tinted <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> for comfort.</li>\n<li>Avoid eye rubbing</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis for a patient who wears contact lenses and has been experiencing eye watering, redness, and a sensation of having a foreign object in the eye for the last two months?", "options": [{"label": "A", "text": "Follicular conjunctivitis", "correct": false}, {"label": "B", "text": "Spring catarrh", "correct": false}, {"label": "C", "text": "Giant papillary conjunctivitis", "correct": true}, {"label": "D", "text": "Acute trachoma", "correct": false}], "correct_answer": "C. Giant papillary conjunctivitis", "question_images": ["https://image.prepladder.com/notes/1lZNwXIubva5XKrizpaf1747911209.png"], "explanation_images": ["https://image.prepladder.com/notes/1lZNwXIubva5XKrizpaf1747911209.png", "https://image.prepladder.com/content/PE5mjCXWAdmllsAS2Yvx1745924832.png", "https://image.prepladder.com/content/demk85egF8UY96LGtcrp1745924832.png", "https://image.prepladder.com/content/6NE1GoqynJ4Pt9i99P7q1745924832.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Specific allergic <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> affecting the superior <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Soft <span class=\"customMeta\" data-dictid=\"db283047011692777189a869dbce07\">hydrophilic</span> <strong>contact lenses</strong></li>\n<li>Protruding <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> ends</li>\n<li>Ocular prostheses</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Underlying Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypersensitivity reactions <strong>(types I and IV)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Itching/ Watering</li>\n<li>Foreign body sensation</li>\n<li>Occasionally blurred vision</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Conjunctival <span class=\"customMeta\" data-dictid=\"2dd9736fdf16927771849f5a925f7d\">congestion</span> predominantly in the upper palpebral region</li>\n<li>Large polygonal <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> on superior <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva</li>\n<li>Macropapillae (0.3-1.0 mm) and giant <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> (1-2 mm)</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\" Giant Papillary Conjunctivitis\" data-author=\"Rosa, Mario &amp; Lionetti, Elena &amp; Reibaldi, Michele &amp; Russo, Andrea &amp; Longo, Antonio &amp; Leonardi, Salvatore &amp; Tomarchio, Stefania &amp; Avitabile, Teresio &amp; Reibaldi, Alfredo\" data-hash=\"13171\" data-license=\"CC BY 2.0\" data-source=\"https://www.researchgate.net/figure/Giant-papillary-conjunctivitis_fig6_235966425\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/1lZNwXIubva5XKrizpaf1747911209.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Discontinue soft contact lenses, remove offending sutures, clean and polish <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> prosthesis; replace with <span class=\"customMeta\" data-dictid=\"ed1050ab241692777183d28df9ecad\">biocompatible</span> material (e.g., Biocoat).</li>\n<li>Ancillary therapy: Mast cell stabilizers (e.g., lodoxamide, <span class=\"customMeta\" data-dictid=\"d3f7cd4f92169277718588c69a0f10\">cromolyn</span> sodium, olopatadine) along with artificial tears, <span class=\"customMeta\" data-dictid=\"4b296ae29b16927771815960a008db\">antihistaminic</span> drops, and decongestants.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the probable diagnosis for the eye lesion observed in a 21-year-old male patient?", "options": [{"label": "A", "text": "Bitot’s spots", "correct": true}, {"label": "B", "text": "Pterygium", "correct": false}, {"label": "C", "text": "Phlyctenular conjunctivitis", "correct": false}, {"label": "D", "text": "Pinguecula", "correct": false}], "correct_answer": "A. Bitot’s spots", "question_images": ["https://image.prepladder.com/content/osQtETyJiJxAbpq0ennE1745920316.png"], "explanation_images": ["https://image.prepladder.com/content/KQ5z9sLHF5rJGc6N2rTi1745920380.png", "https://image.prepladder.com/content/jJx206U0kBz02VoOEqqU1745920416.png", "https://image.prepladder.com/content/Wz05drbfaGE0mv2cY6N91745920398.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:654px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>XN</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Night blindness: Difficulty seeing in low light or at night.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>X1A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Conjunctival xerosis: Dryness of the <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> without foamy patches (Bitot spots).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>X1B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bitot spots:</strong> Presence of foamy, whitish accumulations on the <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> <strong>(Option A)</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Community Eye Health\" data-hash=\"\" data-license=\"CC BY NC 2.0\" data-source=\"https://www.flickr.com/photos/communityeyehealth/5444948403/in/photostream/\" data-tags=\"\" height=\"257\" src=\"https://image.prepladder.com/content/KQ5z9sLHF5rJGc6N2rTi1745920380.png\" width=\"257\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>X2</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Corneal xerosis: The cornea's dryness makes it appear <span class=\"customMeta\" data-dictid=\"68d37494591692777186d7c7ce4531\">dull</span> and hazy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>X3A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Corneal ulceration/keratomalacia (&lt;1/3rd of the cornea)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>X3B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Corneal ulceration/keratomalacia (&gt;1/3rd of the cornea)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>XS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Corneal scar: Scarring of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> resulting from the <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> of ulcers or keratomalacia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>XF</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Xerophthalmic fundus: Retinal changes associated with chronic Vitamin A deficiency.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the causative agent of the sago-grain appearance of the conjunctiva?", "options": [{"label": "A", "text": "Chlamydia trachomatis", "correct": true}, {"label": "B", "text": "Neisseria gonorrhoeae", "correct": false}, {"label": "C", "text": "Haemophilus influenzae", "correct": false}, {"label": "D", "text": "Vitamin A deficiency", "correct": false}], "correct_answer": "A. Chlamydia trachomatis", "question_images": ["https://image.prepladder.com/content/xEpZSaQ2JRHqk5DkFT9B1745919509.png"], "explanation_images": ["https://image.prepladder.com/content/sGxd4Y8uWwuj4kYDj4Ky1745919559.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Signs of active trachoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Signs of <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">cicatricial</span> trachoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li>Conjunctival congestion</li>\n<li>Follicles in the upper <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva: Look like <strong>sago-grains</strong></li>\n</ul>\n<ul>\n<li>Papillary enlargement: red, velvety</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Diane K. Lavett, Van C Lansingh, Marissa J Carter, Kristen A Eckert, Juan Carlos Silva\" data-hash=\"\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Inflammatory-trachoma-with-Follicular-trachoma-TI-TF-stage-Figure-courtesy-of_fig6_237843559\" data-tags=\"\" height=\"320\" src=\"https://image.prepladder.com/content/sGxd4Y8uWwuj4kYDj4Ky1745919559.png\" width=\"447\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li><strong>Scarring </strong>\n<ul>\n<li>It may be irregular, star-shaped, or linear</li>\n<li>Linear <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> in the <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> subtarsalis is called <strong>Arlt’s line</strong></li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>accumulation of dead epithelial cells and <span class=\"customMeta\" data-dictid=\"11d92ee2d916927771907f5dfc40d1\">inspissated</span> <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> in the glands of Henle</li>\n<li>Pseudocyst</li>\n<li>Xerosis</li>\n<li>Symblepharon</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li>Superficial <span class=\"customMeta\" data-dictid=\"f1711947d41692777190ce56ef2f7d\">keratitis</span> on <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp and fluorescein</li>\n<li><strong>Herbert’s follicles </strong></li>\n<li><strong>Progressive </strong>pannus/<strong>Trachomatous pannus</strong>: The <strong>upper part of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is cloudy</strong></li>\n</ul>\n<ul>\n<li><strong>Corneal ulcers </strong>are common at the advancing edge of the pannus\n\n\t\t\t\t<ul>\n<li>Shallow, little infiltrated</li>\n<li>Cause <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> and photophobia</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li><strong>Regressive </strong>pannus or <strong>pannus siccus</strong>:\n\n\t\t\t\t<ul>\n<li>Receding infiltration</li>\n<li>Vessels extend beyond the area of <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> and haze</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Herbert pits</strong>: <span class=\"customMeta\" data-dictid=\"74793d564816927771943ae4ba74b3\">oval</span> or <span class=\"customMeta\" data-dictid=\"0919f0017e1692777184ac3748841f\">circular</span> pitted scars <strong>formed after the <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> of Herbert’s follicles in the <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> area</strong></li>\n</ul>\n<ul>\n<li>Vascularized and <strong>opaque cornea.</strong></li>\n<li>Corneal xerosis</li>\n<li>Corneal ectasia</li>\n<li>Total corneal <span class=\"customMeta\" data-dictid=\"388a4ccfbf1692777194a8f6a2d3b4\">pannus</span> (blinding sequelae)</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lid signs:</strong></p>\n<ul>\n<li>Distortion of the lids</li>\n<li><strong>Tylosis</strong>: Thickening of the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> plate/lid margin</li>\n<li><strong>Trichiasis: </strong>due to <span class=\"customMeta\" data-dictid=\"97ae59957c1692777197359406f6f4\">rubbing</span> of lashes on the cornea</li>\n<li><strong>Trachomatous <span class=\"customMeta\" data-dictid=\"e18c2053271692777194e62a208e01\">ptosis</span> </strong>(sleepy appearance)</li>\n<li><strong>Entropion</strong></li>\n<li>Madarosis</li>\n<li>Ankyloblepharon</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not characteristic of pterygium?", "options": [{"label": "A", "text": "Rate of recurrence is 95%", "correct": true}, {"label": "B", "text": "It is a fibrovascular growth", "correct": false}, {"label": "C", "text": "The parts of a pterygium are the head, neck and body", "correct": false}, {"label": "D", "text": "Has progressive and regressive types", "correct": false}], "correct_answer": "A. Rate of recurrence is 95%", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Fx2e9bCMXWcK0WOO6Rp51745320732.png", "https://image.prepladder.com/notes/XwR46UVmxC2wNQthTyBw1745321045.png", "https://image.prepladder.com/notes/0OUXuzimEySUVvR1JJSg1745321099.png", "https://image.prepladder.com/notes/tlBIMDVQISnt9rIClImV1745321701.png", "https://image.prepladder.com/notes/mXkuc7DFd4BtivR2khvx1745321657.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:714px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pterygium/Surfer’s eye</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pseudopterygium</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pterygium is a triangular encroachment of vascularized <span class=\"customMeta\" data-dictid=\"09e414c5a71692777188ef029aefe5\">granulation</span> tissue covered by <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> in the <span class=\"customMeta\" data-dictid=\"f2a86bcac91692777190f5db6b96ca\">interpalpebral</span> area.</p>\n<img alt=\"Temp Pterygium \" data-author=\"\" data-hash=\"10977\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Fx2e9bCMXWcK0WOO6Rp51745320732.png\"/>\n<ul>\n<li>Parts: Cap, head, neck, body</li>\n<li><strong>Degenerative </strong>process</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pterygium like lesion</li>\n<li>Due to cicatrizing conjunctival <strong>inflammatory </strong>overgrowth</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"Temp Pseudopterygium\" data-author=\" Facundo Urbinati, Davide Borroni, Marina Rodríguez-Calvo-de-Mora, José-María Sánchez-González, María García-Lorente, Francisco Zamorano-Martín, Rahul Rachwani-Anil, Santiago Ortiz-Pérez, Vito Romano and Carlos Rocha-de-Lossada \" data-hash=\"10978\" data-license=\"open access\" data-source=\"https://www.mdpi.com/2075-4418/12/8/1843\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/XwR46UVmxC2wNQthTyBw1745321045.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Aetiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Common in dry, sunny climates with sandy soils</li>\n<li><strong>Ultraviolet light </strong>is a probable factor</li>\n<li>Usually elderly persons</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Seen at any age</li>\n<li>Caused by\n\t\t\t\t<ul>\n<li>Trauma</li>\n<li>Chronic conjunctivitis</li>\n<li>Thermochemical burn</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Pathology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"Temp Pterygium Hpe\" data-author=\"Nephron\" data-hash=\"10979\" data-license=\"CC BY SA 3.0\" data-source=\"https://librepathology.org/wiki/File:Pterygium_-_high_mag.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/0OUXuzimEySUVvR1JJSg1745321099.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<p>Histology shows <strong>collagenous degenerative changes in the vascularized <span class=\"customMeta\" data-dictid=\"94aff4fd141692777199a78b5ed2eb\">subepithelial</span> stroma.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Pathogenesis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Degenerative <span class=\"customMeta\" data-dictid=\"335f16a33c16927771992f5c55bc4d\">subconjunctival</span> proliferation</li>\n<li>Granulation tissue proliferates as avascularized tissue encroaches on the cornea.</li>\n<li>Destroys the <strong>superficial layers of the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> and Bowman’s membrane</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Frequently follows a pinguecula</li>\n<li>Often bilateral</li>\n<li>Usually on the <strong>nasal side</strong></li>\n<li>Impairment of vision due to:\n\t\t\t\t<ul>\n<li>Progression into the pupillary area of the cornea</li>\n<li>Induced <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> by corneal <span class=\"customMeta\" data-dictid=\"13d0edf82916927772021bfc7f9aeb\">flattening</span> in the <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> of pterygium</li>\n</ul>\n</li>\n<li><strong>Progressive </strong>pterygium: thick and vascular</li>\n<li><strong>Regressive </strong>pterygium: thin, pale, and atrophic</li>\n<li>Ceases to grow but never disappears</li>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the lesion</li>\n<li>Can present as <strong>inflamed pterygium</strong></li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"Temp Inflamed Pterygium\" data-author=\"Jmvaras José Miguel Varas, MD\" data-hash=\"10981\" data-license=\"CC BY 3.0\" data-source=\"https://en.wikipedia.org/wiki/Pterygium#/media/File:Pterygium_Slitlamp.jpg\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/tlBIMDVQISnt9rIClImV1745321701.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Non-progressive </strong></li>\n<li>Can be at <strong>any quadrant</strong> of the corneal limbus</li>\n<li>Located away from the horizontal</li>\n<li>Attached to the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> due to <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> tissue</li>\n<li>Adhered to the adjacent lid</li>\n<li>Always <strong>stationary</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> cannot be passed under the lesion</li>\n<li><strong>Fusch’s spots/Islets of Vogt:</strong> small <span class=\"customMeta\" data-dictid=\"635650799116927771862d7cb568f4\">discrete</span> whitish flecks made of pterygial epithelial cells seen in progressive <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> and are also called the <strong>cap </strong>of the pterygium.</li>\n<li><strong>Stocker line: </strong>linear epithelial iron deposition, seen in <span class=\"customMeta\" data-dictid=\"531cf746021692777197c135fbce82\">regressive</span> pterygium.</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"Temp stockers line\" data-author=\"Tae Seen Kang, Jong Joo Lee, Si Hwan Choi\" data-hash=\"10980\" data-license=\"CC BY NC 3.0\" data-source=\"https://www.researchgate.net/figure/Stockers-line-slit-lamp-photo-A-A-64-year-old-male-diagnosed-with-pteygium_fig2_304027779\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/mXkuc7DFd4BtivR2khvx1745321657.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the neck.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is a common ocular finding in pterygium?", "options": [{"label": "A", "text": "Eye pain", "correct": false}, {"label": "B", "text": "Macular edema", "correct": false}, {"label": "C", "text": "Purulent discharge", "correct": false}, {"label": "D", "text": "Astigmatism", "correct": true}], "correct_answer": "D. Astigmatism", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/kX6guUK1IMCrjaxbfSZZ1741790230.png", "https://image.prepladder.com/content/C68nDXmhu4r71HCcDZTy1741790249.png", "https://image.prepladder.com/content/PH65muVLKLRZFN8gm99j1741280182.png", "https://image.prepladder.com/content/g7raglVfDMxfA1THAyj71741790269.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:714px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pterygium/Surfer’s eye</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pseudopterygium</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pterygium is a triangular encroachment of vascularized <span class=\"customMeta\" data-dictid=\"09e414c5a71692777188ef029aefe5\">granulation</span> tissue covered by <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> in the <span class=\"customMeta\" data-dictid=\"f2a86bcac91692777190f5db6b96ca\">interpalpebral</span> area.</p>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"1999\" src=\"https://image.prepladder.com/content/kX6guUK1IMCrjaxbfSZZ1741790230.png\" width=\"4167\"/></p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Parts: Cap, head, neck, body</li>\n<li><strong>Degenerative </strong>process</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pterygium like lesion</li>\n<li>Due to cicatrizing conjunctival <strong>inflammatory </strong>overgrowth</li>\n</ul>\n<p><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"3164\" src=\"https://image.prepladder.com/content/C68nDXmhu4r71HCcDZTy1741790249.png\" width=\"4167\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Aetiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Common in dry, sunny climates with sandy soils</li>\n<li><strong>Ultraviolet light </strong>is a probable factor</li>\n<li>Usually elderly persons</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Seen at any age</li>\n<li>Caused by <strong> </strong>\n<ul>\n<li>Trauma</li>\n<li>Chronic conjunctivitis</li>\n<li>Thermochemical burn</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Pathology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n<p>Histology shows <strong>collagenous degenerative changes in the vascularized <span class=\"customMeta\" data-dictid=\"94aff4fd141692777199a78b5ed2eb\">subepithelial</span> stroma.</strong></p>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"667\" src=\"https://image.prepladder.com/content/PH65muVLKLRZFN8gm99j1741280182.png\" width=\"996\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Pathogenesis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Degenerative <span class=\"customMeta\" data-dictid=\"335f16a33c16927771992f5c55bc4d\">subconjunctival</span> proliferation</li>\n<li>Granulation tissue proliferates as avascularized tissue encroaches on the cornea.</li>\n<li>Destroys the <strong>superficial layers of the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> and Bowman’s membrane</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Frequently follows a pinguecula</li>\n<li>Often bilateral</li>\n<li>Usually on the <strong>nasal side</strong> <strong> </strong></li>\n<li>Impairment of vision due to:\n\t\t\t\t<ul>\n<li>Progression into the pupillary area of the cornea</li>\n<li>Induced <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> by corneal <span class=\"customMeta\" data-dictid=\"13d0edf82916927772021bfc7f9aeb\">flattening</span> in the <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> of pterygium</li>\n</ul>\n</li>\n<li><strong>Progressive </strong>pterygium: thick and vascular</li>\n<li><strong>Regressive </strong>pterygium: thin, pale, and atrophic</li>\n<li>Ceases to grow but never disappears</li>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the lesion</li>\n<li>Can present as <strong>inflammed pterygium</strong></li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Non-progressive </strong></li>\n<li>Can be at <strong>any quadrant</strong> of the corneal limbus</li>\n<li>Located away from the horizontal</li>\n<li>Attached to the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> due to <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> tissue</li>\n<li>Adhered to the adjacent lid</li>\n<li>Always <strong>stationary</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> cannot be passed under the lesion</li>\n<li><strong>Fusch’s spots/Islets of Vogt:</strong> small <span class=\"customMeta\" data-dictid=\"635650799116927771862d7cb568f4\">discrete</span> whitish flecks made of pterygial epithelial cells seen in progressive <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> and are also called the <strong>cap </strong>of the pterygium.</li>\n<li><strong>Stocker line: </strong>linear epithelial iron deposition, seen in <span class=\"customMeta\" data-dictid=\"531cf746021692777197c135fbce82\">regressive</span> pterygium.</li>\n</ul>\n<img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"2297\" src=\"https://image.prepladder.com/content/g7raglVfDMxfA1THAyj71741790269.png\" width=\"4167\"/>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the neck.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:692px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Best left alone</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>Medical treatment: </strong></p>\n<ul>\n<li>Tear substitutes for small <span class=\"customMeta\" data-dictid=\"531cf746021692777197c135fbce82\">regressive</span> <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> with dry eye</li>\n<li>Topical steroids for associated inflammation</li>\n<li>Protection from UV rays with sunglasses</li>\n</ul>\n<p><strong>Surgical <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> for:</strong></p>\n<ul>\n<li>Progression of <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> towards the pupillary area causing excessive <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> and visual impairment</li>\n<li>Restricted <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> movements</li>\n<li>Disfiguring</li>\n<li>Diplopia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Procedures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bare <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> technique:\n\t\t\t\t<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> is excised from the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and conjunctiva, leaving a bare sclera</li>\n<li>Associated with a high <span class=\"customMeta\" data-dictid=\"1d849ebc9b1692777197d4af1fa8d2\">recurrence</span> rate</li>\n</ul>\n</li>\n<li>Autoconjunctival graft\n\t\t\t\t<ul>\n<li>A piece of <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> conjunctival tissue from <strong>the same or the other eye</strong><strong> </strong>or</li>\n<li>An<strong> <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> <span class=\"customMeta\" data-dictid=\"a283380a9a1692777188549537a964\">graft</span> </strong>is used to cover the bare sclera</li>\n<li>Sutured at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> to cover the defect</li>\n</ul>\n</li>\n<li>Surgical <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> with <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> <span class=\"customMeta\" data-dictid=\"8a6b591d1d16927771900a3c620d92\">keratectomy</span> and <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> for deeply infiltrating <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> recalcitrant pterygia</li>\n<li>Old methods (not used now):\n\t\t\t\t<ul>\n<li>McRaynold’s operation</li>\n<li>Postoperative use of <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> irradiations</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Post-operative therapy and care</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prevent recurrence:\n\t\t\t\t<ul>\n<li>Mitomycin C 0.02% drops</li>\n<li>Complications like scleral necrosis, cataracts, and iritis</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is seen in the given image?", "options": [{"label": "A", "text": "Horner trantas spots", "correct": false}, {"label": "B", "text": "Herbert pits", "correct": true}, {"label": "C", "text": "Pannus", "correct": false}, {"label": "D", "text": "Corneal dystrophy", "correct": false}], "correct_answer": "B. Herbert pits", "question_images": ["https://image.prepladder.com/content/Dcs1IbvB8kQYWJ3Pf70X1724830816.png"], "explanation_images": ["https://image.prepladder.com/content/Tg7raRr37edSu1rco9p51724830828.png", "https://image.prepladder.com/content/8qFHp15NzlMbWM4L5rhw1724830896.png", "https://image.prepladder.com/content/8saaQjYxYivx223krD4P1724830941.png", "https://image.prepladder.com/content/QtKtHwDNvmh5DBuUJqL71724830974.png", "https://image.prepladder.com/content/t8X68ecPK4j0iWKg1EdQ1724831027.png"], "explanation": "<p>Correct Option B - H\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A young boy from a poor socioeconomic background presents with hyperemia and yellowish nodules at the limbus. What could be the likely diagnosis?", "options": [{"label": "A", "text": "Bitot’s spots", "correct": false}, {"label": "B", "text": "Pterygium", "correct": false}, {"label": "C", "text": "Pinguecula", "correct": false}, {"label": "D", "text": "Phlyctenular conjunctivitis", "correct": true}], "correct_answer": "D. Phlyctenular conjunctivitis", "question_images": ["https://image.prepladder.com/content/0A9jd8sss3bmCnDpAUeX1747305260.png"], "explanation_images": ["https://image.prepladder.com/content/m5SmoNDj6vjTtszwEYnA1747305306.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Phlyctenular keratoconjunctivitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Allergic reactions to <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> antigens are often <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to bacterial infections such as <strong>Staphylococcus aureus </strong>(M/C/C in Western countries)<strong> </strong> or <strong>tuberculosis</strong>(M/C/C in India).</p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Arpitha Muthialu, MD, Lauren E. Jensen, and Michael Wagoner, MD, PhD\" data-hash=\"\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/cases/89_phlyctenular-keratoconjunctivitis-staphylococcal-blepharitis.htm#gsc.tab=0\" data-tags=\"\" height=\"311\" src=\"https://image.prepladder.com/content/m5SmoNDj6vjTtszwEYnA1747305306.png\" width=\"512\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Symptoms &amp; signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Watering, itching</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"540b75eeb516927771831794d7ce0f\">blepharospasm</span> (involuntary blinking)</li>\n<li>Conjunctival congestion</li>\n<li><strong>Phlycten - Small, round, grayish, or yellowish nodules on the <span class=\"customMeta\" data-dictid=\"ef00544aba1692777183bc916b1c30\">bulbar</span> <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> near the limbus</strong>.</li>\n<li>Corneal involvement can lead to <span class=\"customMeta\" data-dictid=\"ee875e7c3416927772026804e2e155\">fascicular</span> ulcers or ring ulcers.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p><strong>Type IV <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reaction.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Common Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p><strong>Corneal involvement:</strong> Ulcers <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> on the cornea, leading to potential scarring.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Associated Conditions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Long-standing mild infections like <strong>tonsillitis</strong> or <strong>adenoiditis</strong>, and in populations with a high <span class=\"customMeta\" data-dictid=\"f86aae0bd61692777196f91458c9dd\">prevalence</span> of <strong>tuberculosis</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p><strong>Local therapy:</strong></p>\n<ul>\n<li>Corticosteroids: Drops/ointment to reduce inflammation. Address underlying cause (e.g., tuberculosis).</li>\n<li>Antibiotics</li>\n<li>Cycloplegics: Paralyze <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle, relieve pain, and prevent complications.</li>\n<li>Dark Glasses/Eye Shade: For <span class=\"customMeta\" data-dictid=\"46e2a1c298169277719583f46ff587\">photophobia</span> relief.</li>\n</ul>\n<p><strong>General therapy:</strong></p>\n<ul>\n<li>Oral <span class=\"customMeta\" data-dictid=\"8784b5a7ad16927772005323b514b8\">tetracycline</span> or <span class=\"customMeta\" data-dictid=\"d0f202322516927771863db87b76e7\">doxycycline</span> is used in <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> cases <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to Staphylococcal blepharitis.</li>\n</ul>\n<p><strong>Supportive:</strong> Dark <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> or eye shade.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is associated with Vitamin A deficiency?", "options": [{"label": "A", "text": "Pinguecula", "correct": false}, {"label": "B", "text": "Bitot’s spots", "correct": true}, {"label": "C", "text": "Pterygium", "correct": false}, {"label": "D", "text": "Stocker’s line", "correct": false}], "correct_answer": "B. Bitot’s spots", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>XN</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Night blindness.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>X1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>X1A: Conjunctival xerosis.</li>\n<li>X1B: Bitot spots. <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>X2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Corneal xerosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>X3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>X3A: Corneal ulceration, less than one-third.</li>\n<li>X3B: Corneal ulceration, more than one-third.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>XS</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Corneal scar.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>XF</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Xerophthalmic fundus.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the normal conjunctival flora?", "options": [{"label": "A", "text": "Staph aureus", "correct": false}, {"label": "B", "text": "Staph Epidermidis", "correct": true}, {"label": "C", "text": "Strep. Pneumonia", "correct": false}, {"label": "D", "text": "H. influenzae", "correct": false}], "correct_answer": "B. Staph Epidermidis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KpvmEPKxClAfguJliSaG1747219727.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inflammation of inner structures of the eye (uveal tissue and retina) with exudates in the vitreous, anterior, and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> chambers. It spares sclera.</li>\n<li><strong>Acute bacterial <span class=\"customMeta\" data-dictid=\"d7e86ebfd9169277718767de545052\">endophthalmitis</span> happens 1-7 days post <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> surgery.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>M/C <span class=\"customMeta\" data-dictid=\"f616aee08b169277718361438e1a91\">causative</span> organism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Staphylococcus epidermidis (Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Presentation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> pain</li>\n<li>Redness</li>\n<li>Lacrimation</li>\n<li>Photophobia</li>\n<li>Loss of vision</li>\n<li>Red and swollen lids</li>\n<li>Conjunctival chemosis</li>\n<li>Circumcorneal congestion</li>\n<li>Cloudy cornea</li>\n<li>Ring infiltration</li>\n<li>Yellow necrotic wound edges</li>\n<li>Hypopyon</li>\n<li>Oedematous and muddy iris</li>\n<li>Yellow <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> due to <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> exudation</li>\n<li>Vitreous <span class=\"customMeta\" data-dictid=\"1f6bbb967d16927771871c1894ea2e\">exudation</span> which causes amaurotic cat's-eye reflex</li>\n<li>Raised <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure initially</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Intravitreal antibiotics:\n\t\t\t\t<ul>\n<li>First choice: Vancomycin 1 mg + Ceftazidime 2.25 mg</li>\n<li>Second choice: Vancomycin 1 mg + Amikacin 0.4 mg</li>\n</ul>\n</li>\n<li>Topical antibiotics</li>\n<li>Systemic antibiotics</li>\n<li>Steroid Therapy</li>\n<li>Supportive Therapy</li>\n<li><strong>Vitrectomy - if no improvement in 48-72 hours or if severe infection with vision <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> to hand movements close to the face</strong></li>\n<li>If blind - no perception of light - Evisceration.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the causative agent of the ocular condition as shown in the image?", "options": [{"label": "A", "text": "Chlamydia", "correct": true}, {"label": "B", "text": "Mycoplasma", "correct": false}, {"label": "C", "text": "Pseudomonas", "correct": false}, {"label": "D", "text": "Staphylococcus", "correct": false}], "correct_answer": "A. Chlamydia", "question_images": ["https://image.prepladder.com/content/ZqOF7impKWcguh7e59jo1746007009.png"], "explanation_images": ["https://image.prepladder.com/content/6qRU3qQTT3veNY0Esb0A1746007041.png", "https://image.prepladder.com/content/kQC4vlu4sHdLVbxhavf41746007041.png", "https://image.prepladder.com/content/wFz6mMkapbt6NrSLuSYe1746007041.png", "https://image.prepladder.com/content/bCnZL3gr6i5ej7smIbsZ1746007041.png", "https://image.prepladder.com/content/Uegopj58hPj505ezccRB1746007041.png", "https://image.prepladder.com/content/6IArARju6k0WDkXGiNht1746007041.png", "https://image.prepladder.com/content/0R7vnZJDDBm9hWgDIAO71746007041.png", "https://image.prepladder.com/content/7w51z44Rbb4gUlLnkHmv1746007042.png", "https://image.prepladder.com/content/N3Z25A6X5qsXp5VEWsBI1746007041.png", "https://image.prepladder.com/notes/S38XFjeBthMlthxZKBB91746183773.png", "https://image.prepladder.com/notes/kO1OyWzCyI5GhHqG2SBq1746183985.png", "https://image.prepladder.com/notes/EUQx6M5dKyVAH5R39S2U1746184118.png", "https://image.prepladder.com/notes/zolSzJwYvA5XwtFJ3KQ51746184206.png", "https://image.prepladder.com/notes/P94ekTdH6Sl5c3xUkAwp1746184345.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Signs of active trachoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Signs of <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">cicatricial</span> trachoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li>Conjunctival congestion</li>\n<li>Follicles in the upper <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva: Look like sago-grains</li>\n</ul>\n<ul>\n<li>Papillary enlargement: red, velvety</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li><strong>Scarring </strong>\n<ul>\n<li>It may be irregular, star-shaped, or linear</li>\n<li>Linear <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> in the <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> subtarsalis is called <strong>Arlt’s line</strong></li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>accumulation of dead epithelial cells and <span class=\"customMeta\" data-dictid=\"11d92ee2d916927771907f5dfc40d1\">inspissated</span> <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> in the glands of Henle</li>\n<li>Pseudocyst</li>\n<li>Xerosis</li>\n<li>Symblepharon</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li>Superficial <span class=\"customMeta\" data-dictid=\"f1711947d41692777190ce56ef2f7d\">keratitis</span> on <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp and fluorescein</li>\n<li><strong>Herbert’s follicles </strong></li>\n<li><strong>Progressive </strong>pannus/<strong>Trachomatous pannus</strong>: The <strong>upper part of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is cloudy</strong></li>\n</ul>\n<ul>\n<li><strong>Corneal ulcers </strong>are common at the advancing edge of the pannus\n\n\t\t\t\t<ul>\n<li>Shallow, little infiltrated</li>\n<li>Cause <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> and photophobia</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li><strong>Regressive </strong>pannus or <strong>pannus siccus</strong>:\n\n\t\t\t\t<ul>\n<li>Receding infiltration</li>\n<li>Vessels extend beyond the area of <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> and haze</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Herbert pits</strong>: <span class=\"customMeta\" data-dictid=\"74793d564816927771943ae4ba74b3\">oval</span> or <span class=\"customMeta\" data-dictid=\"0919f0017e1692777184ac3748841f\">circular</span> pitted scars <strong>formed after the <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> of Herbert’s follicles in the <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> area</strong></li>\n</ul>\n<ul>\n<li>Vascularized and <strong>opaque cornea.</strong></li>\n<li>Corneal xerosis</li>\n<li>Corneal ectasia</li>\n<li>Total corneal <span class=\"customMeta\" data-dictid=\"388a4ccfbf1692777194a8f6a2d3b4\">pannus</span> (blinding sequelae)</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lid signs:</strong></p>\n<ul>\n<li>Distortion of the lids</li>\n<li><strong>Tylosis</strong>: Thickening of the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> plate/lid margin</li>\n<li><strong>Trichiasis </strong>due to <span class=\"customMeta\" data-dictid=\"97ae59957c1692777197359406f6f4\">rubbing</span> of lashes on the cornea</li>\n<li><strong>Trachomatous <span class=\"customMeta\" data-dictid=\"e18c2053271692777194e62a208e01\">ptosis</span> </strong>(sleepy appearance)</li>\n<li><strong>Entropion</strong></li>\n<li>Madarosis</li>\n<li>Ankyloblepharon</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lacrimal <span class=\"customMeta\" data-dictid=\"5a70fb96bf1692777181823f42fcf0\">apparatus</span> sequelae:</strong></p>\n<ul>\n<li>Chronic dacryocystitis</li>\n<li>Chronic dacryoadenitis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:789px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Active <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">Trachoma</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Victor H Hu, Martin J Holland, Matthew J Burton\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"\" height=\"207\" src=\"https://image.prepladder.com/content/6qRU3qQTT3veNY0Esb0A1746007041.png\" width=\"344\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\">Follicles in upper palpebral conjunctiva</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Kawashima, Motoko &amp; Kawakita, Tetsuya &amp; Higa, Kazunari &amp; Satake, Yoshiyuki &amp; Omoto, Masahiro &amp; Tsubota, Kazuo &amp; Shimmura, Shigeto &amp; Shimazaki, Jun.\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Histopathology-of-pannus-Clinical-appearance-of-patient-case-7-showed-thin-pannus_fig1_49703223\" data-tags=\"\" height=\"224\" src=\"https://image.prepladder.com/content/kQC4vlu4sHdLVbxhavf41746007041.png\" width=\"332\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"259\" src=\"https://image.prepladder.com/content/wFz6mMkapbt6NrSLuSYe1746007041.png\" width=\"259\"/></p>\n<p style=\"text-align: center;\">Progressive pannus</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Cicatricial </strong></p>\n<p><strong>Trachoma </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"\" height=\"171\" src=\"https://image.prepladder.com/content/bCnZL3gr6i5ej7smIbsZ1746007041.png\" width=\"344\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Justin Risma, MD ,Stefani Karakas, CRA\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/herberts-pits.htm#gsc.tab=0\" data-tags=\"\" height=\"157\" src=\"https://image.prepladder.com/content/Uegopj58hPj505ezccRB1746007041.png\" width=\"332\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"259\" src=\"https://image.prepladder.com/content/6IArARju6k0WDkXGiNht1746007041.png\" width=\"259\"/></p>\n<p>Regressive pannus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://eyerounds.org/atlas/pages/nidus-of-tarsal-conjunctival-concretions-meibomian-infarct.html#gsc.tab=0V\" data-tags=\"\" height=\"318\" src=\"https://image.prepladder.com/content/0R7vnZJDDBm9hWgDIAO71746007041.png\" width=\"344\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\">Conjunctival concretions</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"\" height=\"218\" src=\"https://image.prepladder.com/content/7w51z44Rbb4gUlLnkHmv1746007042.png\" width=\"332\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\">Trichiasis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"\" height=\"144\" src=\"https://image.prepladder.com/content/N3Z25A6X5qsXp5VEWsBI1746007041.png\" width=\"258\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align: center;\">Tylosis (thickening of <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> border of eyelid)</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:710px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>WHO Classification of <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">Trachoma</span> (FISTO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TF</strong>:</p>\n<p>Trachomatous Inflammation- <strong>Follicular </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The presence of five or more follicles in the upper <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva<strong> </strong></li>\n<li>Active stage of trachoma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\" Trachomatous inflammation 1\" data-author=\"Victor H Hu, Martin J Holland, Matthew J Burton\" data-hash=\"11544\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/S38XFjeBthMlthxZKBB91746183773.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Antibiotics to eliminate the organism</li>\n<li>Topical:\n\t\t\t\t<ul>\n<li>Tetracycline 1% or</li>\n<li>Erythromycin 1%</li>\n<li>Sulfacetamide</li>\n</ul>\n</li>\n<li>Systemic:\n\t\t\t\t<ul>\n<li>Tetracycline or <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> orally</li>\n<li>Doxycycline orally</li>\n<li>Azithromycin single oral dose</li>\n</ul>\n</li>\n<li>Combined <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> and <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> therapy:\n\t\t\t\t<ul>\n<li>For TI or when an associated <span class=\"customMeta\" data-dictid=\"0e919a208b16927771885d9c1f6662\">genital</span> infection is present</li>\n<li>Tetracycline 1% or <span class=\"customMeta\" data-dictid=\"259b36252716927771879987e01054\">erythromycin</span> 1% eye ointment</li>\n<li>Azithromycin orally</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TI</strong>: Trachamatous Inflammation- <strong>Intense</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pronounced <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> thickening of the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> that obscures more than half of the normal deep <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> vessels.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Trachamatous Inflammation Intense\" data-author=\"Hu, Victor &amp; Holland, Martin &amp; Burton, Matthew.\" data-hash=\"11545\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/kO1OyWzCyI5GhHqG2SBq1746183985.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TS: </strong>Trachamatous <strong>Scarring </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Presence of <span class=\"customMeta\" data-dictid=\"e9dcc3d4241692777198c7030bf313\">scarring</span> in <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva</li>\n<li>White, bands or sheets of <span class=\"customMeta\" data-dictid=\"21e2d5a70616927772021fcdec0ca9\">fibrosis</span> in <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\" TRACHOMA SCARRING\" data-author=\"Diane K. Lavett, Van C Lansingh, Marissa J Carter, Kristen A Eckert, Juan Carlos Silva\" data-hash=\"11546\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Trachomatous-scarring-TS-stage-Figure-courtesy-of-Hollman-Miller-Vaupes-Colombia_fig8_237843559\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/EUQx6M5dKyVAH5R39S2U1746184118.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Concretions removed with a <span class=\"customMeta\" data-dictid=\"e978bee5781692777189dddd001d74\">hypodermic</span> needle</li>\n<li>Conjunctival <span class=\"customMeta\" data-dictid=\"9a100e80c71692777202114329893c\">xerosis</span> with artificial <span class=\"customMeta\" data-dictid=\"1717bdb5d21692777200d45e31ceed\">tears</span> (lubricating drops)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>TT: </strong>Trachamatous <strong>Trichiasis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>At least one <span class=\"customMeta\" data-dictid=\"5b4dd03e7d16927771877ac3787035\">eyelash</span> rub on <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> or evidence of recent removal of inturned eyelashes.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Trichiasis\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"11547\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/zolSzJwYvA5XwtFJ3KQ51746184206.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Permanent lash removal</strong>:\n\t\t\t\t<ul>\n<li>Electrolysis</li>\n<li>Cryolysis</li>\n<li>Radiofrequency epilation</li>\n<li>Bilamellar <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> resection</li>\n</ul>\n</li>\n<li>Cicatricial <span class=\"customMeta\" data-dictid=\"bcd6d163731692777187fccac22750\">entropion</span> surgery</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CO: Corneal Opacity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Easily visible corneal <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> over the pupil</li>\n<li>Part of the <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> margin is blurred when seen through the <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> as it is very dense corneal scarring</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Trachomatous inflammation 5\" data-author=\"Victor H Hu, Martin J Holland, Matthew J Burton\" data-hash=\"11548\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Clinical-features-and-grades-of-trachoma-N-normal-TF-Trachomatous_fig7_235778578\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/P94ekTdH6Sl5c3xUkAwp1746184345.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>After treatment of other <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">trachoma</span> sequelae</li>\n<li><strong>Penetrating <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> </strong>for significant corneal scarring</li>\n<li><strong>Keratoprosthesis </strong>for <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> blind cases with extensive <span class=\"customMeta\" data-dictid=\"e9dcc3d4241692777198c7030bf313\">scarring</span> and surface problems</li>\n<li><strong>Punctal <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> </strong>and <strong>lateral <span class=\"customMeta\" data-dictid=\"9d7ef2a8991692777200bbed2388b0\">tarsorrhaphy</span> </strong>for coexistent eye surface problems</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most frequently observed eye symptom associated with COVID-19?", "options": [{"label": "A", "text": "Uveitis", "correct": false}, {"label": "B", "text": "Mucormycosis", "correct": false}, {"label": "C", "text": "Follicular conjunctivitis", "correct": true}, {"label": "D", "text": "Papillary conjunctivitis", "correct": false}], "correct_answer": "C. Follicular conjunctivitis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Ophthalmic conditions associated with COVID-19</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Conditions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Conjunctiva</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Acute conjunctivitis</li>\n<li>Unremitting conjunctivitis</li>\n<li>Mild <span class=\"customMeta\" data-dictid=\"031a38f17a16927772036476ede2ae\">follicular</span> conjunctivitis</li>\n<li>Severe hemorrhagic conjunctivitis</li>\n<li>Pseudomembrane formation</li>\n<li>Keratoconjunctivitis</li>\n<li>Kawasaki-like illness (MIS-C)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Sclera/Episclera</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Episcleritis</li>\n<li>Nodular episcleritis</li>\n<li>Necrotizing <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> scleritis</li>\n<li>Sectoral <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> scleritis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Anterior Chamber</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis</li>\n<li>Reactivated <span class=\"customMeta\" data-dictid=\"4acddc3cf5169277718996440e2e14\">idiopathic</span> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Retina and Choroid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> occlusion</li>\n<li>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> occlusion</li>\n<li>Acute <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"44820414a616927771935e4c59f7fc\">neuroretinopathy</span> (AMN)</li>\n<li>Paracentral <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> middle <span class=\"customMeta\" data-dictid=\"e2819a366f1692777191b1bf2bb04f\">maculopathy</span> (PAMM)</li>\n<li>Purtscher-like retinopathy</li>\n<li>Retinal hemorrhages</li>\n<li>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots</li>\n<li>Dilated veins</li>\n<li>Tortuous vessels</li>\n<li>Multifocal <span class=\"customMeta\" data-dictid=\"91606261e316927771844d1049c97b\">choroiditis</span> (associated with vaccine)</li>\n<li>Serpiginous and ampiginous choroiditis</li>\n<li>Acute <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> (due to <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> virus reactivation)</li>\n<li>Retinal vasculitis</li>\n<li>Retinal degeneration</li>\n<li>Breakdown of blood-retinal barrier</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Optic neuritis</li>\n<li>Neuromyelitis optica spectrum disorder</li>\n<li>Anti-myelin <span class=\"customMeta\" data-dictid=\"853eda0c8b16927771945a8590a405\">oligodendrocyte</span> <span class=\"customMeta\" data-dictid=\"6c9fa3a73216927771888299c86e08\">glycoprotein</span> (anti-MOG) antibodies</li>\n<li>Papilledema</li>\n<li>Elevated <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure (pseudotumor <span class=\"customMeta\" data-dictid=\"5a4a970c4b1692777184108b0b09c8\">cerebri</span> syndrome)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Extraocular Motility, <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">Cranial</span> Nerves</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Cranial nerve III, IV, VI palsies</li>\n<li>Binocular diplopia</li>\n<li>Ocular <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> neuropathies</li>\n<li>Postinfectious demyelinating conditions (e.g., Miller-Fisher syndrome, Guillain-Barré syndrome)</li>\n<li>Ocular <span class=\"customMeta\" data-dictid=\"6fa809ad22169277719323eaa30f1e\">myasthenia</span> gravis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Pupils</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Mydriasis</li>\n<li>Cholinergic super-sensitivity</li>\n<li>Tonic pupils</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Nystagmus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Visual disturbances (oscillopsia)</li>\n<li>Viral-induced <span class=\"customMeta\" data-dictid=\"e8b3c606051692777201faf2a1a357\">vestibular</span> neuritis</li>\n<li>Central <span class=\"customMeta\" data-dictid=\"e8b3c606051692777201faf2a1a357\">vestibular</span> <span class=\"customMeta\" data-dictid=\"1ca218aa7e1692777193e1da961e31\">nystagmus</span> (associated with rhombencephalitis)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Visual Cortex</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Acute stroke affecting <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> visual pathways</li>\n<li>Homonymous <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> deficits</li>\n<li>Posterior cerebral <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> ischemic strokes</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Orbit and <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">Ocular</span> Adnexa</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Sinusitis</li>\n<li>Orbital cellulitis</li>\n<li>Bacterial <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> abscess</li>\n<li>Invasive fungal rhino-orbital mucormycosis</li>\n<li>Orbital myositis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Lacrimal System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Epiphora (tear overproduction)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Manifestations in Newborn Infants</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Periorbital edema</li>\n<li>Chemosis</li>\n<li>Hemorrhagic conjunctivitis</li>\n<li>Ciliary injection</li>\n<li>Corneal edema</li>\n<li>Rubeosis</li>\n<li>Posterior synechiae</li>\n<li>Retinopathy of prematurity</li>\n<li>Vitreous hemorrhage</li>\n<li>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the recommended approach for managing a middle-aged woman with a progressive pterygium that is extending towards the pupillary area?", "options": [{"label": "A", "text": "Keratoplasty", "correct": false}, {"label": "B", "text": "Excision with conjunctival autograft", "correct": true}, {"label": "C", "text": "Observation", "correct": false}, {"label": "D", "text": "Beta-radiation", "correct": false}], "correct_answer": "B. Excision with conjunctival autograft", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Excision with conjunctival autog\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most effective treatment for a patient who experiences considerable discomfort when reading text from paper or a screen, despite having normal visual acuity and other eye examination findings, except for a Schirmer's test result of 5mm?", "options": [{"label": "A", "text": "Steroids", "correct": false}, {"label": "B", "text": "Anti-histamine", "correct": false}, {"label": "C", "text": "Lubricating eye drops", "correct": true}, {"label": "D", "text": "Prescribed spectacles", "correct": false}], "correct_answer": "C. Lubricating eye drops", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Lubricating\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis for a 5-year-old boy who is experiencing severe itching, and thick discharge from his eyes . Upon examination the following finding as shown in the image was observed.", "options": [{"label": "A", "text": "Trachoma", "correct": false}, {"label": "B", "text": "Vernal keratoconjunctivitis", "correct": true}, {"label": "C", "text": "Phylctenular conjunctivitis", "correct": false}, {"label": "D", "text": "Xerophthalmia", "correct": false}], "correct_answer": "B. Vernal keratoconjunctivitis", "question_images": ["https://image.prepladder.com/content/2LN8yLVW5UZ5T6Tba1uH1714041118.png"], "explanation_images": ["https://image.prepladder.com/content/3pyxJfyMl6X9tKAxGity1714041190.png"], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"b2a2e3ba5c1692777201528ac05837\"&gt;Vernal&lt;/span&gt; keratoconjunctiv\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the clinical condition", "options": [{"label": "A", "text": "Herpes simplex keratitis", "correct": false}, {"label": "B", "text": "Bacterial keratitis", "correct": false}, {"label": "C", "text": "Mycotic keratitis", "correct": false}, {"label": "D", "text": "Vernal keratoconjunctivitis", "correct": true}], "correct_answer": "D. Vernal keratoconjunctivitis", "question_images": ["https://image.prepladder.com/content/P3trN2h9iWXHbqHtgLif1715848403.png"], "explanation_images": [], "explanation": "<p>Correct Option D - Vernal keratoconjunctiv\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the cause of phlyctenular conjunctivitis?", "options": [{"label": "A", "text": "Atropine", "correct": false}, {"label": "B", "text": "Asthma", "correct": false}, {"label": "C", "text": "Contact lens", "correct": false}, {"label": "D", "text": "Tuberculous proteins", "correct": true}], "correct_answer": "D. Tuberculous proteins", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ZTQmOHMDsBtPfrWPcnTb1714042025.png"], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"a50c41365a1692777201501cb6b378\"&gt;Tuberculous&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis from the image given below?", "options": [{"label": "A", "text": "Pinguecula", "correct": false}, {"label": "B", "text": "Concretions", "correct": false}, {"label": "C", "text": "Pterygium", "correct": true}, {"label": "D", "text": "Bitot's spots", "correct": false}], "correct_answer": "C. Pterygium", "question_images": ["https://image.prepladder.com/content/ie9iOms4Qz0AQ6PqFGBp1691505622.png"], "explanation_images": [], "explanation": "<p>Correct Option C - Pterygiu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which microorganism is responsible for angular conjunctivitis?", "options": [{"label": "A", "text": "Moraxella lacunata", "correct": true}, {"label": "B", "text": "Haemophilus influenzae", "correct": false}, {"label": "C", "text": "Adenovirus type 32", "correct": false}, {"label": "D", "text": "Coxsackie B virus", "correct": false}], "correct_answer": "A. Moraxella lacunata", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/GimnTPcIWzJILhFHNq1l1695189058.png"], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"e641ced0f016927771926ee6999bbb\"&gt;Moraxella&lt;/span&gt; lacu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In developed countries, what is the primary etiology responsible for ophthalmia neonatorum ?", "options": [{"label": "A", "text": "Chlamydia", "correct": true}, {"label": "B", "text": "Gonorrhoea", "correct": false}, {"label": "C", "text": "Chemical conjunctivitis", "correct": false}, {"label": "D", "text": "Staphylococcus aureus", "correct": false}], "correct_answer": "A. Chlamydia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Ch\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the underlying factor responsible for the development of acute hemorrhagic conjunctivitis ?", "options": [{"label": "A", "text": "Enterovirus 68", "correct": false}, {"label": "B", "text": "Enterovirus 72", "correct": false}, {"label": "C", "text": "Enterovirus 70", "correct": true}, {"label": "D", "text": "Enterovirus 71", "correct": false}], "correct_answer": "C. Enterovirus 70", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"808ea4002d16927771876fa4cb31f7\"&gt;Enterovirus&lt;/span&gt; 7\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "True about pterygium:", "options": [{"label": "A", "text": "Inflammation of cornea", "correct": false}, {"label": "B", "text": "Fatty deposition of sclera", "correct": false}, {"label": "C", "text": "Conjunctival invasion making a flap over cornea", "correct": true}, {"label": "D", "text": "Dead epithelial debris accumulation", "correct": false}], "correct_answer": "C. Conjunctival invasion making a flap over cornea", "question_images": [], "explanation_images": [], "explanation": "<p>Correct option C - Conjunctival invasion making a &lt;span class=\"customMeta\" data-dictid=\"7eae099d8d1692777202469603e6ed\"&gt;flap&lt;/span&gt; ov\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 39 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following is not an indication of Penetrating Keratoplasty (PK)?", "options": [{"label": "A", "text": "Corneal opacity", "correct": false}, {"label": "B", "text": "Cosmetic improvement of the eye", "correct": false}, {"label": "C", "text": "Advanced keratoconus", "correct": false}, {"label": "D", "text": "Secondary glaucoma", "correct": true}], "correct_answer": "D. Secondary glaucoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/kBiCS5mNIqH8hsoO3cka1743057838.png", "https://image.prepladder.com/notes/rDMurhsu6uf17T5sGkCk1743057867.png", "https://image.prepladder.com/notes/Sdg01xJHXuLJv51OApcY1743057891.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Optical</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Corneal <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> <strong>(Option A ruled out)</strong></li>\n<li>Bullous keratopathy</li>\n<li>Corneal dystrophies</li>\n<li>Advanced <span class=\"customMeta\" data-dictid=\"5f67be2f821692777190c29974efe2\">keratoconus</span> <strong>(Option C ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Therapeutic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To replace an inflamed <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> that does not respond to conventional therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tectonic Graft</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To restore the integrity of the eyeball, e.g., after corneal <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> or in cases of significant corneal thinning.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cosmetic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To improve the appearance of the eye <strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZBuOPbOCkIG5vj0lU6ia1746871802.mp3", "video": ""}, {"text": "A 30 y/o contact lens wearer presents with very severe eye pain, blurred vision, and discomfort in his right eye. O/E, the following corneal finding is noted. Based on the image and the clinical presentation, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Herpes Simplex Keratitis", "correct": false}, {"label": "B", "text": "Fungal Keratitis", "correct": false}, {"label": "C", "text": "Acanthamoeba Keratitis", "correct": true}, {"label": "D", "text": "Bacterial Keratitis", "correct": false}], "correct_answer": "C. Acanthamoeba Keratitis", "question_images": ["https://image.prepladder.com/notes/ZfRMU4ZruQMoKKHIn0sI1746785905.png"], "explanation_images": ["https://image.prepladder.com/notes/lV1RtFNxCtlbknmeCdGC1746785970.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lVvLtIrm8BKWQwDigK3d1746776392.mp3", "video": ""}, {"text": "Match the Following: 1) a) Bacterial Keratitis 2) b) Superficial Punctate Keratitis 3) c) Pseudodendritis 4) d) Dendritic Ulcer 5) e) Nummular Keratitis 6) f) Fungal Keratitis", "options": [{"label": "A", "text": "1-b; 2-e; 3-c; 4-f; 5-d; 6-a", "correct": false}, {"label": "B", "text": "1-c; 2-e; 3-d; 4-f; 5-a; 6-b", "correct": false}, {"label": "C", "text": "1-e; 2-c; 3-b; 4-f; 5-d; 6-a", "correct": false}, {"label": "D", "text": "1-c; 2-e; 3-b; 4-f; 5-d; 6-a", "correct": true}], "correct_answer": "D. 1-c; 2-e; 3-b; 4-f; 5-d; 6-a", "question_images": ["https://image.prepladder.com/notes/kmfO1OwzshaEZu8XKzgf1743745020.png", "https://image.prepladder.com/notes/60BbNbEVjJ5sqZOkJGEr1743055233.png", "https://image.prepladder.com/notes/WMt60FWyxjtEfSC5QjyZ1743055288.png", "https://image.prepladder.com/notes/HTFd2TElp6cqFtYHfxay1743055330.png", "https://image.prepladder.com/notes/vxBUB8ISSEp3pHCQsfla1743745065.png", "https://image.prepladder.com/notes/iUZQ9wVvhWXidZNz7Tof1743055348.png"], "explanation_images": ["https://image.prepladder.com/notes/iUZQ9wVvhWXidZNz7Tof1743055348.png", "https://image.prepladder.com/notes/HTFd2TElp6cqFtYHfxay1743055330.png", "https://image.prepladder.com/notes/WMt60FWyxjtEfSC5QjyZ1743055288.png", "https://image.prepladder.com/notes/60BbNbEVjJ5sqZOkJGEr1743055233.png", "https://image.prepladder.com/notes/vxBUB8ISSEp3pHCQsfla1743745065.png", "https://image.prepladder.com/notes/kmfO1OwzshaEZu8XKzgf1743745020.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacterial Keratitis:</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Bacterial Keratitis\" data-author=\"Fadlallah, Ali &amp; Chelala, Elias &amp; Legeais, Jean-Marc.\" data-hash=\"2975\" data-license=\"CC BY 4.0\" data-source=\"Slit Lamp photo showing active bacterial keratitis. | Download Scientific Diagram (researchgate.net)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/iUZQ9wVvhWXidZNz7Tof1743055348.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A corneal epithelial <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> with an <span class=\"customMeta\" data-dictid=\"8fd5e2898d16927771900855b98180\">infiltrate</span> (a larger area of corneal involvement) and significant <span class=\"customMeta\" data-dictid=\"44275429861692777184e2adf7aa8d\">circumcorneal</span> injection, often with a hypopyon.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fungal Keratitis:</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Fungal Keratitis\" data-author=\"M. Upadhyay, M. Srinivasan, J. Whitcher\" data-hash=\"2974\" data-license=\"NA\" data-source=\"Figure 1 from Diagnosing and managing microbial keratitis | Semantic Scholar\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/HTFd2TElp6cqFtYHfxay1743055330.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<br/>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Grey or yellow-white stromal <span class=\"customMeta\" data-dictid=\"8fd5e2898d16927771900855b98180\">infiltrate</span> with indistinct fluffy margins, often with satellite lesions, or a yellow-white densely <span class=\"customMeta\" data-dictid=\"a48a50d87216927771994f1cfe9b7d\">suppurative</span> <span class=\"customMeta\" data-dictid=\"8fd5e2898d16927771900855b98180\">infiltrate</span> in Candida keratitis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superficial <span class=\"customMeta\" data-dictid=\"77074d46b51692777196747de93965\">Punctate</span> Keratitis:</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Superficial Punctate Keratitis\" data-author=\"Okoro, Chiemela &amp; Amiebenomo, Onyeka &amp; Aruotu, Nwakuso\" data-hash=\"2973\" data-license=\"CC BY 4.0\" data-source=\"Extensive superficial punctate staining; this could be caused by... | Download Scientific Diagram (researchgate.net)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/WMt60FWyxjtEfSC5QjyZ1743055288.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>This term describes any corneal epithelial <span class=\"customMeta\" data-dictid=\"4586eccbe71692777186e577e31829\">disturbance</span> with a dot-like morphology, including conditions like Thygeson <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> <span class=\"customMeta\" data-dictid=\"77074d46b51692777196747de93965\">punctate</span> keratitis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nummular Keratitis:</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Nummular Keratitis \" data-author=\"Jkokavec\" data-hash=\"2972\" data-license=\"CC BY-SA 3.0\" data-source=\"Nummular keratitis 1 - Nummular keratitis - Wikipedia\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/60BbNbEVjJ5sqZOkJGEr1743055233.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Characterized by fine <span class=\"customMeta\" data-dictid=\"4f63eb15be169277718848d4b4978b\">granular</span> <span class=\"customMeta\" data-dictid=\"94aff4fd141692777199a78b5ed2eb\">subepithelial</span> deposits surrounded by a <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> of stromal haze.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dendritic Ulcer:</strong></p>\n<p><img alt=\"Dendritic ulcer\" data-author=\"\" data-hash=\"7257\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/vxBUB8ISSEp3pHCQsfla1743745065.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Linear branching <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> with <span class=\"customMeta\" data-dictid=\"16b76d1d1c1692777200240efcb0e2\">terminal</span> bulbs, the base of which stains well with fluorescein, and where the virus-laden cells at the margin of the <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> <span class=\"customMeta\" data-dictid=\"b29a1a16ab1692777199ede1c6e28b\">stain</span> with rose Bengal.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pseudodendritis:</strong></p>\n<p><img alt=\"pseudodendritis\" data-author=\"\" data-hash=\"7256\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/kmfO1OwzshaEZu8XKzgf1743745020.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Corneal epithelial lesions that are smaller and finer than <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> simplex dendrites, have tapered ends without <span class=\"customMeta\" data-dictid=\"16b76d1d1c1692777200240efcb0e2\">terminal</span> bulbs, and <span class=\"customMeta\" data-dictid=\"b29a1a16ab1692777199ede1c6e28b\">stain</span> better with rose Bengal than with fluorescein.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/49RevU3Eibiy8i2NByab1745225785.mp3", "video": ""}, {"text": "A 28-year-old female contact lens wearer with severe eye pain and blurred vision shows a ring-shaped corneal infiltrate, and radial keratoneuritis on examination. Corneal scraping showed the presence of cysts. What is the most appropriate initial treatment?", "options": [{"label": "A", "text": "Topical moxifloxacin", "correct": false}, {"label": "B", "text": "Oral acyclovir", "correct": false}, {"label": "C", "text": "Topical polyhexamethylene biguanide (PHMB)", "correct": true}, {"label": "D", "text": "Topical corticosteroids", "correct": false}], "correct_answer": "C. Topical polyhexamethylene biguanide (PHMB)", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/P7mPMOWjuRWkCt4gl9sV1746776928.mp3", "video": ""}, {"text": "A 23 y/o male presents with B/L eye redness, pain, and severe blurring of vision. He has a history of congenital syphilis. O/E, there is a characteristic pinkish-red discolouration of the cornea with deep stromal vascularization. Which of the following findings is most likely associated with this patient's condition during the healing stage?", "options": [{"label": "A", "text": "Pseudodendrites", "correct": false}, {"label": "B", "text": "Ghost vessels", "correct": true}, {"label": "C", "text": "Ring-shaped abscess", "correct": false}, {"label": "D", "text": "Radial keratoneuritis", "correct": false}], "correct_answer": "B. Ghost vessels", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ramR50PvQUfqLYl8WHiG1743056495.png", "https://image.prepladder.com/notes/1hQdXEFKksd9QdHb3Cz11743056512.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis: Pain, redness, photophobia, blurred vision.</p>\n<p>Severe blurring of vision during the active phase.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Signs: Active Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Salmon Patch Appearance</strong>: Pinkish-red discoloration due to deep stromal <span class=\"customMeta\" data-dictid=\"eba212cd6616927772014f0fc1ccfd\">vascularization</span> and clouding.</li>\n<li><strong>Limbitis</strong>: <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">Inflammation</span> at the corneal-scleral junction.</li>\n<li><strong>Granulomatous <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> Uveitis</strong>: Large <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> deposits (keratic precipitates) on the corneal endothelium.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Signs: <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">Healing</span> Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Ghost Vessels</strong>: Empty blood vessels leaving faint tracks.</li>\n<li><strong>Stromal Scarring</strong>: Feathery appearance from scarring.</li>\n<li><strong>Corneal Thinning</strong>: This may lead to <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> and vision impairment.</li>\n<li><strong>Band Keratopathy</strong>: <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">Calcium</span> deposition as a late complication.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/l15g3wAdunepP9rR0L2G1746777731.mp3", "video": ""}, {"text": "A 19 y/o female presents with a history of progressive worsening of vision that is not fully corrected by glasses. After evaluation, she is diagnosed with keratoconus. Which of the following examination findings are seen in keratoconus? Munson's sign Scissor reflex Vogt striae Fleischer ring", "options": [{"label": "A", "text": "1,2,3,4", "correct": true}, {"label": "B", "text": "1,3,4", "correct": false}, {"label": "C", "text": "2,3,4", "correct": false}, {"label": "D", "text": "1,4", "correct": false}], "correct_answer": "A. 1,2,3,4", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/6XirQEOcvvwFCIsBd4aZ1743056781.png", "https://image.prepladder.com/notes/ptLp9FMz1ZCmhKvzztRN1743057115.png", "https://image.prepladder.com/notes/qsWPXNU2uShI3RK0XwrF1743057076.png", "https://image.prepladder.com/notes/9D3bfIfmAVGmy1UrxM9q1743057093.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Jswz2VqUzYn9EfHF568X1746866862.mp3", "video": ""}, {"text": "Question: A 22 y/o male with a history of worsening vision despite wearing rigid gas-permeable lenses now complains of increased visual distortion. O/E, his corneal topography shows progressive ectasia, and he is advised to consider treatment options to halt disease progression. Which of the following treatments is most appropriate to stabilize the condition and improve contact lens tolerance in this patient?", "options": [{"label": "A", "text": "Spectacle correction", "correct": false}, {"label": "B", "text": "Intracorneal ring segments (INTACS)", "correct": false}, {"label": "C", "text": "Corneal collagen cross-linking (CXL)", "correct": true}, {"label": "D", "text": "Penetrating keratoplasty", "correct": false}], "correct_answer": "C. Corneal collagen cross-linking (CXL)", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/oFf3Wj2fygXbahODJFGF1746867350.mp3", "video": ""}, {"text": "A 50 y/o patient presents for a corneal transplant evaluation. The patient has a history of systemic infections, including tuberculosis, and is seeking a corneal graft for a therapeutic indication. Which of the following is an absolute contraindication for cornea donation in this patient?", "options": [{"label": "A", "text": "Death due to an unknown cause", "correct": true}, {"label": "B", "text": "Previous history of ocular surgery", "correct": false}, {"label": "C", "text": "Ocular inflammation", "correct": false}, {"label": "D", "text": "Retinoblastoma", "correct": false}], "correct_answer": "A. Death due to an unknown cause", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Absolute contraindications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Relative contraindications</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1) Death due to an unknown cause</p>\n\t\t\t \n\n\t\t\t<p>2) <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">Systemic</span> infections</p>\n<ul>\n<li>HIV</li>\n<li>Hepatitis</li>\n<li>Congenital rubella</li>\n<li>TB</li>\n<li>Syphilis</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>3) <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> infection or diseases</p>\n<ul>\n<li>Multiple sclerosis</li>\n<li>Rabies</li>\n<li>Creutzfeldt-Jakob disease</li>\n</ul>\n\t\t\t \n\n\t\t\t<p>4) Most haematological malignancies</p>\n<ul>\n<li>Leukaemia</li>\n<li>Lymphoma</li>\n<li>Myeloma and other <span class=\"customMeta\" data-dictid=\"8dd789d7d1169277719303d4744837\">myeloproliferative</span> disorders and syndromes</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ocular <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> <strong>(Option C ruled out)</strong></li>\n<li>Any <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> or <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> disorders of the Eye or previous <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> surgery (including corneal laser surgery) <strong>(Option B ruled out)</strong></li>\n<li>Retinoblastoma <strong>(Option D ruled out)</strong></li>\n<li>Malignant tumours or <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> <span class=\"customMeta\" data-dictid=\"ee33485c641692777192b16b999489\">metastases</span> in the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> segment of the eye.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FO1ZT6snjwv1c06TZ9561746867800.mp3", "video": ""}, {"text": "A donor cornea is harvested and needs to be preserved for a planned corneal transplant for 10 days. Which of the following storage methods is most appropriate for preserving the donor cornea?", "options": [{"label": "A", "text": "Moist Chamber Method", "correct": false}, {"label": "B", "text": "McCarey Kaufman (M-K) Medium", "correct": false}, {"label": "C", "text": "Optisol GS", "correct": true}, {"label": "D", "text": "Cryopreservation", "correct": false}], "correct_answer": "C. Optisol GS", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Short-term Storage </strong></p>\n<p style=\"text-align:center\"><strong>(24 to 96 hours)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Intermediate-term Storage </strong></p>\n<p style=\"text-align:center\"><strong>(up to 2 weeks)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Long-term Preservation </strong></p>\n<p style=\"text-align:center\"><strong>(months to years)</strong>:</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Moist Chamber Method</strong>: Preserve the whole globe at 4°C in a refrigerator for up to 48 hours.</li>\n<li><strong>McCarey Kaufman (M-K) Medium</strong>:</li>\n<li>Pink-colored medium containing TC-199, Dextran-40, HEPES buffer, and gentamicin.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Optisol GS</strong>:</li>\n<li>Contains chondroitin sulfate, dextran, ascorbic acid, vitamin B12, ATP precursors, gentamicin, and streptomycin.</li>\n<li><strong>Other Media</strong>: Cornisol, Eusol, and Life-GE medium also available for up to 2 weeks.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Glycerine Preservation</strong>: Effective for 3-4 weeks.</li>\n<li><strong>Organ Culture Method</strong>: Preserves <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> at 30°C to 37°C for up to 35 days.</li>\n<li><strong>Cryopreservation</strong>: Preserves corneal button at -70°C for up to 1 year.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wyxtzUjNvlQy8jcURr891746871256.mp3", "video": ""}, {"text": "A 70 y/o woman presents with severe pain in her right eye and forehead, along with a rash that started 5 days ago. She was diagnosed with Herpes Zoster Ophthalmicus (HZO). Which of the following statements is true regarding the management of her condition?", "options": [{"label": "A", "text": "Systemic steroids alone are sufficient to manage HZO", "correct": false}, {"label": "B", "text": "Antiviral therapy is started within 72 hours of rash onset.", "correct": true}, {"label": "C", "text": "Postherpetic neuralgia is less common in patients over 70 years of age.", "correct": false}, {"label": "D", "text": "Topical antiviral therapy is not recommended to manage eye involvement in HZO.", "correct": false}], "correct_answer": "B. Antiviral therapy is started within 72 hours of rash onset.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2yXn7LAkuBBnA5uhx2Xw1746775505.mp3", "video": ""}, {"text": "A 45 y/o patient presents with worsening vision, mild pain, and redness 6 months after Penetrating Keratoplasty. Examination reveals the following. Which feature is most indicative of endothelial rejection?", "options": [{"label": "A", "text": "Increased Flare and Cells", "correct": false}, {"label": "B", "text": "Kayes dots", "correct": false}, {"label": "C", "text": "Khodadoust Line", "correct": true}, {"label": "D", "text": "Epithelial Rejection Line", "correct": false}], "correct_answer": "C. Khodadoust Line", "question_images": ["https://image.prepladder.com/notes/Fg041DpM3g7fcO8CT3V31743058360.png"], "explanation_images": ["https://image.prepladder.com/notes/BAH4HxEnpq9lEeU6p4kW1743058405.png", "https://image.prepladder.com/notes/tGitFwpE9n4QCxbErTvg1743058420.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/C7T7CQQ61JZwn4KuG2fq1746872278.mp3", "video": ""}, {"text": "All of the following statements about lamellar keratoplasty are true except:", "options": [{"label": "A", "text": "It is indicated in pseudophakic bullous keratopathy", "correct": true}, {"label": "B", "text": "It has lower risk of graft rejection compared to Penetrating keratoplasty", "correct": false}, {"label": "C", "text": "Deep Anterior Lamellar Keratoplasty (DALK) replaces 80-90% of the anterior stroma and is suitable when the endothelium is normal.", "correct": false}, {"label": "D", "text": "Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) is performed when the endothelium is defective.", "correct": false}], "correct_answer": "A. It is indicated in pseudophakic bullous keratopathy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/p6Q3rZ4uQmClxbrWRM7M1743058708.png", "https://image.prepladder.com/notes/ciQsA1fkaIbskt8UOjNA1743058858.png", "https://image.prepladder.com/notes/xwlUiA6vhKn77hCTfeR11743058878.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OPDzu827dML1EQ3DY5pe1746872695.mp3", "video": ""}, {"text": "Match the following: 1) Arcus senilis a) 2) Band shaped Keratopatthy b) 3) Vortex keratopathy c) 4) Salzmann nodular degeneration d)", "options": [{"label": "A", "text": "1-b, 2-d, 3-a, 4-c", "correct": true}, {"label": "B", "text": "1-d, 2-a, 3-c, 4-b", "correct": false}, {"label": "C", "text": "1-c, 2-d, 3-b, 4-a", "correct": false}, {"label": "D", "text": "1-a, 2-b, 3-c, 4-d", "correct": false}], "correct_answer": "A. 1-b, 2-d, 3-a, 4-c", "question_images": ["https://image.prepladder.com/notes/LbbOkxByOwe7tUQKukZt1746879664.png", "https://image.prepladder.com/notes/tLS20Hszd2FNvQx7iLYx1743062233.png", "https://image.prepladder.com/notes/MLeD69oNJTiKPShRyGSo1748316363.png", "https://image.prepladder.com/notes/NjlpPTDP20x9dFTvnoHW1743062255.png"], "explanation_images": ["https://image.prepladder.com/notes/tLS20Hszd2FNvQx7iLYx1743062233.png", "https://image.prepladder.com/notes/NjlpPTDP20x9dFTvnoHW1743062255.png", "https://image.prepladder.com/notes/LbbOkxByOwe7tUQKukZt1746879664.png", "https://image.prepladder.com/notes/MLeD69oNJTiKPShRyGSo1748316363.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>CORNEAL DEGENERATION</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>IMAGE</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Arcus Senilis </u></strong><strong> </strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Lipoid <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> of the cornea. It is common in the elderly.</li>\n<li>Begins as a <span class=\"customMeta\" data-dictid=\"c22cf6658416927771856f7516a87e\">crescentic</span> grey or whitish <span class=\"customMeta\" data-dictid=\"2207398c591692777182d7ac096dbc\">arc</span> around the corneal margins.</li>\n<li>Extends to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> a complete <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> ring around the cornea.</li>\n<li>Thicker at the top and bottom; sharply defined on the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> side, <span class=\"customMeta\" data-dictid=\"28b8100e7b1692777202be12974004\">fading</span> towards the centre.</li>\n<li>Typically no more than 1 mm wide.</li>\n<li>Does not affect vision or corneal vitality.</li>\n<li>Unrelated to secondary hypercholesterolemia.</li>\n<li>Round <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> at a young age is called <strong>arcus juvenilis</strong>, caused by dyslipidemia.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Arcus Senilis\" data-author=\"Afrodriguezg\" data-hash=\"3139\" data-license=\"CC BY-SA 4.0\" data-source=\"File:Arcus Senilis.jpg - Wikimedia Commons\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/tLS20Hszd2FNvQx7iLYx1743062233.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Band Shaped <span class=\"customMeta\" data-dictid=\"05446ed9961692777190f3aa32fb8f\">Keratopathy</span> </u></strong></p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Common in chronic uveitis, aphakic eyes with prolonged <span class=\"customMeta\" data-dictid=\"a4609c06fd16927771983dad60e1a3\">silicone</span> oil, and occasionally <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to <span class=\"customMeta\" data-dictid=\"a21c150dc716927771893624a49628\">hyperparathyroidism</span> or vitamin D poisoning.</li>\n<li>Characterized by a whitish band across the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> with round ‘holes’ or cleaves.</li>\n<li>Caused by <span class=\"customMeta\" data-dictid=\"a2ce88e8a0169277718988f5bc31b8\">hyaline</span> <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> and deposition of <span class=\"customMeta\" data-dictid=\"881718e2951692777183cee81b0da6\">calcareous</span> salts in the <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> stroma.</li>\n<li>Treatment options include scraping off the opacity, dissolving it with sodium edetate, or using an excimer laser.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Band Shaped Keratopathy\" data-author=\"Varsha Madanlal, Sharadini Vyas, Virender Sangwan\" data-hash=\"3141\" data-license=\"CC BY-NC-SA 3.0\" data-source=\"Band-shaped keratopathy obscuring the visual axis with no view of pupil... | Download Scientific Diagram (researchgate.net)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/NjlpPTDP20x9dFTvnoHW1743062255.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Vortex keratopathy</u></strong></p>\n<ul>\n<li><strong>Vortex keratopathy</strong>, also known as <strong>corneal verticillata.</strong></li>\n<li>It<strong> </strong>is a distinctive pattern of <strong>corneal epithelial deposits</strong> that appear as <strong>whorl-like (vortex) lines</strong> swirling outward toward the <span class=\"customMeta\" data-dictid=\"316866040e1692777195f45393e010\">periphery</span> of the cornea.</li>\n<li>Etiology:\n\t\t\t\t<ul>\n<li>Drugs: Chloroquine, Amiodarone (dose related), Tamoxifen, Indomethacin, Netarsudil.</li>\n<li>Fabry disease</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Vortex keratopathy\" data-author=\"\" data-hash=\"12462\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/LbbOkxByOwe7tUQKukZt1746879664.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Salzmann <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> degeneration</u></strong><strong> </strong></p>\n<ul>\n<li>A degenerative condition of the cornea.</li>\n<li>Bluish-white, <span class=\"customMeta\" data-dictid=\"a44009963c1692777182feb479b12b\">avascular</span> nodules.</li>\n<li>Located in the <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> and Bowman’s membrane.</li>\n<li>Typically occurs in individuals with a history of previous corneal disease.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Salzmann nodular degeneration\" data-author=\"\" data-hash=\"13283\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/MLeD69oNJTiKPShRyGSo1748316363.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bK2WQjeUvI34dOO2Nt9F1748247362.mp3", "video": ""}, {"text": "Which of the following statements about corneal degeneration is incorrect?", "options": [{"label": "A", "text": "Salzmann nodular degeneration affects the superficial stroma and Bowman’s membrane.", "correct": false}, {"label": "B", "text": "Vortex keratopathy is generally asymptomatic and associated with indomethacin intake.", "correct": false}, {"label": "C", "text": "Lipid keratopathy involves both intracellular and extracellular fat deposits.", "correct": false}, {"label": "D", "text": "Vortex keratopathy remains permanent even after discontinuing the offending medication.", "correct": true}], "correct_answer": "D. Vortex keratopathy remains permanent even after discontinuing the offending medication.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ulMHf5GMDvyY7qeisOUb1743062896.png", "https://image.prepladder.com/notes/9MhboyeO9bO77RPZHmHg1743062991.png", "https://image.prepladder.com/notes/NNrfkYc3LpB8Ccr4UIxK1743062291.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>CORNEAL DEGENERATION</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>IMAGE</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Vortex <span class=\"customMeta\" data-dictid=\"05446ed9961692777190f3aa32fb8f\">Keratopathy</span> / <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">Cornea</span> verticillata</u></strong></p>\n<ul>\n<li>Whorl-like <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> in the corneal epithelium.</li>\n<li><strong>Causes:</strong> Long-term use of medications like <strong>amiodarone, chloroquine, phenothiazines, netrasudil and indomethacin</strong>, or associated with <strong>Fabry disease</strong>. <strong>(Option B ruled out)</strong></li>\n<li><strong>Symptoms:</strong> Generally <span class=\"customMeta\" data-dictid=\"d1a9a79f701692777182066af09044\">asymptomatic</span> and harmless; can cause <span class=\"customMeta\" data-dictid=\"2c2842c6fd169277718825590c6099\">glare</span> and surface discomfort.</li>\n<li><strong>Reversibility:</strong> The condition is <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> upon stopping the offending medication. <strong>(Option D)</strong></li>\n<li><strong>Treatment:</strong> Surface discomfort may be managed with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> lubricants.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Vortex Keratopathy\" data-author=\"Alessandro P Burlina, Katherine B Sims, Juan M Politei, Gary J Bennett, Ralf Baron, Claudia Sommer, Anette Torvin Møller and Max J Hilz - Alessandro P Burlina, Katherine B Sims, Juan M Politei, Gary J Bennett, Ralf Baron, Claudia Sommer, Anette Torvin Møller and Max J Hilz\" data-hash=\"3146\" data-license=\"CC BY 2.0\" data-source=\"Morbus Fabry Cornea verticillata 01 - Cornea verticillata - Wikipedia\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/ulMHf5GMDvyY7qeisOUb1743062896.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Lipid Keratopathy</u></strong><strong> </strong></p>\n<ul>\n<li>Whitish or yellowish deposits in the cornea, composed mainly of cholesterol and <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acids.</li>\n<li><strong>Primary <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">Lipid</span> Keratopathy:</strong> Rare, <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> levels are normal.</li>\n<li><strong>Secondary <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">Lipid</span> Keratopathy:</strong> Occurs in vascularized corneas due to diseases like corneal infections, <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> keratitis, <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> trauma, glaucoma, or chronic iridocyclitis.</li>\n<li><strong>Fat Deposits:</strong> Initially <span class=\"customMeta\" data-dictid=\"a621be29da16927771901bc91014d1\">intracellular</span> but may become <span class=\"customMeta\" data-dictid=\"ba366417791692777187229d34e597\">extracellular</span> with <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> of stromal cells. <strong>(Option C ruled out)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Lipid Keratopathy\" data-author=\"N. Bilen, M. C. Ozmen, B. Aydın\" data-hash=\"3147\" data-license=\"CC BY NC ND 4.0\" data-source=\"Figure 2 from Lipid Keratopathy Due to Presumed Herpes Simplex Keratitis: Case Report | Semantic Scholar\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/9MhboyeO9bO77RPZHmHg1743062991.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Salzmann <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> degeneration</u></strong><strong> </strong></p>\n<ul>\n<li>A degenerative condition of the cornea.</li>\n<li>Bluish-white, <span class=\"customMeta\" data-dictid=\"a44009963c1692777182feb479b12b\">avascular</span> nodules.</li>\n<li>Located in the <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> and Bowman’s membrane. <strong>(Option A ruled out)</strong></li>\n<li>Typically occurs in individuals with a history of previous corneal disease.</li>\n<li>Tends to be slowly progressive.</li>\n<li>May be treated with <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> keratoplasty.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Salzmann nodular degeneration \" data-author=\"S. V. Trufanov, I. A. Riks, M. Ezugbaya\" data-hash=\"3143\" data-license=\"CC BY 4.0\" data-source=\"Salzmann's nodular degeneration. Nodules with vascularization and... | Download Scientific Diagram (researchgate.net)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/NNrfkYc3LpB8Ccr4UIxK1743062291.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CO4N1a0TiS887jFz2ybV1746874949.mp3", "video": ""}, {"text": "A 45 y/o male presents with progressively worsening vision in his left eye over the past year. O/E, the following findings were observed which caused significant blurring of his vision. Which of the following corneal opacities is most likely causing the greatest reduction in his vision?", "options": [{"label": "A", "text": "Nebular corneal opacity", "correct": true}, {"label": "B", "text": "Macular corneal opacity", "correct": false}, {"label": "C", "text": "Leucomatous corneal opacity", "correct": false}, {"label": "D", "text": "Adherent leucoma", "correct": false}], "correct_answer": "A. Nebular corneal opacity", "question_images": ["https://image.prepladder.com/notes/Gz6Ll1EzAo6NfMrl0wD91743063124.png"], "explanation_images": ["https://image.prepladder.com/notes/FWZE60zyXp2jOguyeVoX1743063296.png", "https://image.prepladder.com/notes/RIMCjokspTrQXjZMaB0d1743063325.png"], "explanation": "<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AX4rnWRFF0Trnf5qcS4I1746875483.mp3", "video": ""}, {"text": "A 25-year-old patient presents with a history of gradual vision loss. O/E, multiple milky, granular deposits are seen in the anterior corneal stroma, with clear cornea between the deposits. Which type of stromal corneal dystrophy is most likely?", "options": [{"label": "A", "text": "Granular Corneal Dystrophy, Type 1 (GCD1)", "correct": true}, {"label": "B", "text": "Lattice Corneal Dystrophy, Type 1 (LCD1)", "correct": false}, {"label": "C", "text": "Macular Corneal Dystrophy (MCD)", "correct": false}, {"label": "D", "text": "Schnyder Corneal Dystrophy (SCD)", "correct": false}], "correct_answer": "A. Granular Corneal Dystrophy, Type 1 (GCD1)", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Stromal Dystrophies</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>TGFB1 Corneal Dystrophies </strong></p>\n<p style=\"text-align: center;\">These dystrophies are associated with mutations in the TGFB1 gene</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lattice Corneal <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">Dystrophy</span> (LCD)</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option B ruled out)</strong></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marked by <span class=\"customMeta\" data-dictid=\"51ad856e041692777181f80c9d507a\">amyloid</span> deposits that <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> a lattice-like pattern within the corneal stroma. There are two subtypes:</p>\n<ul>\n<li><strong>LCD1</strong>: Typically presents in early childhood with <span class=\"customMeta\" data-dictid=\"f0677e85e11692777191488c775c17\">lattice</span> lines that spare the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> cornea, leading to <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> erosions and visual impairment.</li>\n<li><strong>LCD2 (Gelsolin Type)</strong>: Appears later in life and begins with <span class=\"customMeta\" data-dictid=\"f0677e85e11692777191488c775c17\">lattice</span> lines in the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> cornea, gradually affecting the centre.</li>\n</ul>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Lattice Corneal Dystrophy\" custommeta\"=\"\" data-author=\"Jesse Vislisel\" data-dictid=\"f0677e85e11692777191488c775c17\" data-hash=\"3172\" data-license=\"CC BY-NC-ND 3.0\" data-source=\"Atlas Entry - &lt;span class=\"/>Lattice corneal <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">dystrophy</span> (uiowa.edu)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/IWfAdcFCrK87hOqGr6lO1743067499.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Granular Corneal <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">Dystrophy</span> (GCD)</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option A)</strong></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It is characterized by the deposition of <strong>hyaline</strong> material within the corneal stroma, with the following subtypes:</p>\n<ul>\n<li><strong>GCD1 (Classic)</strong>:<strong> Presents in childhood with milky, <span class=\"customMeta\" data-dictid=\"4f63eb15be169277718848d4b4978b\">granular</span> deposits in the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> stroma.</strong></li>\n<li><strong>GCD2 (Granular-Lattice)</strong>: Features both <span class=\"customMeta\" data-dictid=\"4f63eb15be169277718848d4b4978b\">granular</span> and lattice-like deposits, usually appearing in the first decade of life.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Granular Corneal Dystrophy\" custommeta\"=\"\" data-author=\"David Phillips\" data-dictid=\"4f63eb15be169277718848d4b4978b\" data-hash=\"3173\" data-license=\"CC BY-NC-ND 3.0\" data-source=\"Atlas Entry - &lt;span class=\"/>Granular corneal <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">dystrophy</span> (uiowa.edu)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/6Kh7ugTr5oeWG1QnYwAk1743067515.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Other Stromal Dystrophies</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Macular Corneal <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">Dystrophy</span> (MCD)</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inherited in an autosomal <span class=\"customMeta\" data-dictid=\"d54db2110416927771971e7c011a9f\">recessive</span> pattern, this <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">dystrophy</span> is characterized by <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> stromal haze and macular-shaped opacities, often causing significant visual <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> in childhood or early adulthood.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Schnyder Corneal <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">Dystrophy</span> (SCD)</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>An autosomal dominant condition marked by the deposition of <strong>cholesterol crystals</strong> in the corneal stroma, leading to ring-shaped opacities and progressive vision loss.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UOAVZdb66m4qN3sU0kjI1746876193.mp3", "video": ""}, {"text": "Which of the following conditions is most commonly associated with the development of a \"beaten-metal\" appearance on the cornea?", "options": [{"label": "A", "text": "Posterior Polymorphous Corneal Dystrophy (PPCD)", "correct": false}, {"label": "B", "text": "Congenital Hereditary Endothelial Dystrophy (CHED)", "correct": false}, {"label": "C", "text": "Keratoconus", "correct": false}, {"label": "D", "text": "Fuchs Endothelial Corneal Dystrophy (FECD)", "correct": true}], "correct_answer": "D. Fuchs Endothelial Corneal Dystrophy (FECD)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pIhLhUvxTH4gzvBvsmb41743067743.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0mkLtbLaqFAwrfENvzCv1746876499.mp3", "video": ""}, {"text": "Match the following. A. 1. Rose bengal B. 2. Lissamine green C. 3. Fluorescein sodium", "options": [{"label": "A", "text": "A-2, B-3, C-1", "correct": false}, {"label": "B", "text": "A-1, B-2, C-3", "correct": false}, {"label": "C", "text": "A-3, B-2, C-1", "correct": true}, {"label": "D", "text": "A-1, B-3, C-2", "correct": false}], "correct_answer": "C. A-3, B-2, C-1", "question_images": ["https://image.prepladder.com/notes/KhZPVRhTEzjDosnYC0041743068028.png", "https://image.prepladder.com/notes/pjMVLP2nkMCx9m0KZYia1743068045.png", "https://image.prepladder.com/notes/TS85h87PrRJBJ5Iff5wI1743068063.png"], "explanation_images": ["https://image.prepladder.com/notes/KhZPVRhTEzjDosnYC0041743068028.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RDRgb5SZrTWrb3Py146H1746876756.mp3", "video": ""}, {"text": "A 55 y/o male with poorly controlled diabetes presents with a non-healing corneal ulcer in his right eye, despite two weeks of appropriate antibiotic therapy. The ulcer shows signs of impending perforation with severe thinning of the cornea. Which of the following is the most appropriate next step in the management of this patient?", "options": [{"label": "A", "text": "Increase the frequency of antibiotic eye drops.", "correct": false}, {"label": "B", "text": "Apply a pressure bandage and recommend strict bed rest.", "correct": false}, {"label": "C", "text": "Perform mechanical debridement and apply tissue adhesive glue.", "correct": true}, {"label": "D", "text": "Start topical steroids to reduce inflammation.", "correct": false}], "correct_answer": "C. Perform mechanical debridement and apply tissue adhesive glue.", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Management of Non-Healing Ulcers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Management of Impending Perforation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Identify and Remove Causes</strong>: Local factors (e.g., ↑ IOP, foreign bodies, dacryocystitis) and <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> factors (e.g., diabetes, malnutrition) causing non-healing.</li>\n<li><strong>Mechanical Debridement</strong>: Scrape the <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> floor to remove necrotic material under local anaesthesia to promote healing.</li>\n<li><strong>Cauterization</strong>: Using pure <span class=\"customMeta\" data-dictid=\"6d1f123ee21692777183f3fcf75999\">carbolic acid</span> or 10-20% <span class=\"customMeta\" data-dictid=\"8c99460f21169277720025f264451b\">trichloroacetic acid</span> in non-responding cases.</li>\n<li><strong>Bandage Soft Contact Lens</strong>: To aid <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> by protecting the corneal surface.</li>\n<li><strong>Peritomy</strong>: Sever perilimbal conjunctival vessels to reduce excessive <span class=\"customMeta\" data-dictid=\"eba212cd6616927772014f0fc1ccfd\">vascularization</span> hindering healing.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Avoid Strain</strong>: Avoid sneezing, coughing, and straining, and maintain strict bed rest.</li>\n<li><strong>Pressure Bandage</strong>: To provide external support to the cornea.</li>\n<li><strong>Lower Intraocular Pressure</strong>: Use acetazolamide, mannitol, oral glycerol, <span class=\"customMeta\" data-dictid=\"44f66117c1169277720085f515550a\">timolol</span> eye drops, and <span class=\"customMeta\" data-dictid=\"8a5aef3208169277719438fb31e654\">paracentesis</span> if needed.</li>\n<li><strong>Tissue <span class=\"customMeta\" data-dictid=\"396cb274df16927771803e151a1109\">Adhesive</span> Glue</strong>: Apply <span class=\"customMeta\" data-dictid=\"20b8709b3f16927771854c0f33e547\">cyanoacrylate</span> <span class=\"customMeta\" data-dictid=\"ffd65f286616927771883be907f80a\">glue</span> to prevent perforation, if <strong>perforation &lt;2mm</strong>.</li>\n<li><strong>Bandage Soft Contact Lens</strong>: Used to support and protect the cornea.</li>\n<li><strong>Conjunctival Flap</strong>: Cover the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> partially or completely with a conjunctival <span class=\"customMeta\" data-dictid=\"7eae099d8d1692777202469603e6ed\">flap</span> for additional support.</li>\n<li><strong>Amniotic Membrane Transplantation</strong></li>\n<li><strong>Penetrating Therapeutic Keratoplasty</strong>: Perform a <span class=\"customMeta\" data-dictid=\"0315dc9e8716927772005cf30b836c\">tectonic</span> <span class=\"customMeta\" data-dictid=\"a283380a9a1692777188549537a964\">graft</span> if suitable and available to prevent <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> or repair a <span class=\"customMeta\" data-dictid=\"eabd01cba8169277719581b5b4420b\">perforated</span> <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> if <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> &gt;2-4mm.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/a9TGKYkGkF9L0guyH93u1746700880.mp3", "video": ""}, {"text": "Which layer of the cornea is primarily responsible for maintaining its transparency by regulating fluid content?", "options": [{"label": "A", "text": "Stroma", "correct": false}, {"label": "B", "text": "Endothelium", "correct": true}, {"label": "C", "text": "Epithelium", "correct": false}, {"label": "D", "text": "Bowman's Membrane", "correct": false}], "correct_answer": "B. Endothelium", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/1x76M5iHuS7sd5QMIQUV1742990549.png", "https://image.prepladder.com/notes/NItXAWpLdQfpXo6YtO6d1742990576.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Layers of Cornea</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Epithelium</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The outermost layer comprises 5-6 layers of non-keratinized, <span class=\"customMeta\" data-dictid=\"e2f163c4cd1692777199def45e74f1\">stratified</span> <span class=\"customMeta\" data-dictid=\"5be0ee4ea316927771997104326685\">squamous</span> epithelial cells.</li>\n<li>Acts as a barrier, protecting the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and preventing tear fluid from entering the underlying stroma.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> cells at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> are stem cells responsible for <strong>regenerating </strong>the corneal epithelium.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bowman’s Membrane</strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Located just beneath the epithelium, this <span class=\"customMeta\" data-dictid=\"adb93c1540169277718043552b7de2\">acellular</span> layer is 12 µm thick and composed of densely packed <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> fibrils.</li>\n<li>It is a <span class=\"customMeta\" data-dictid=\"7958e897a6169277719621e27063ed\">protective barrier</span> to the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> but cannot regenerate if damaged and heals by scarring.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stroma</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Making up about 90% of the cornea's <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> (approximately 0.5 mm thick), the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> consists of <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> fibrils arranged in <span class=\"customMeta\" data-dictid=\"635a7ea50e16927771944f08f17aed\">parallel</span> layers.</li>\n<li>These fibrils are embedded in a <span class=\"customMeta\" data-dictid=\"341e757ca9169277718922ba058b1d\">hydrated</span> <span class=\"customMeta\" data-dictid=\"14958c535b1692777192abd2a85abf\">matrix</span> of proteoglycans - <strong>Chondroitin and Keratan Sulphate </strong>(keratan sulphate maintains corneal transparency).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pre-Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> (Dua's Layer)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This layer, discovered in 2013, is about 15 µm thick, acellular, and lies just above Descemet's membrane.</li>\n<li>It is strong and resistant to air penetration.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Descemet's Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"e901999ab1169277719729899ebdee\">robust</span> basement <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> of the <span class=\"customMeta\" data-dictid=\"8aa7d6c2901692777185d83f2308c8\">corneal endothelium</span> is made of <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> and glycoproteins.</li>\n<li>It is tense, but when torn, curls inwards on itself.</li>\n<li>It can regenerate if damaged and is resistant to trauma and <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> processes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Endothelium</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The innermost layer consists of a single layer of flat, hexagonal cells.</li>\n<li><strong>These cells are crucial for maintaining corneal transparency by regulating <span class=\"customMeta\" data-dictid=\"98d46770fc1692777202253fb59fe9\">fluid balance</span> within the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> through an active pump mechanism.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bTWUcJc9EIvQyJ3Ci2PD1746695877.mp3", "video": ""}, {"text": "What is the primary metabolism of cornea?", "options": [{"label": "A", "text": "Anaerobic", "correct": false}, {"label": "B", "text": "Aerobic.", "correct": true}, {"label": "C", "text": "Both anaerobic and aerobic", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Aerobic.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uFtNeZKaoVhlMaxTqppz1746696095.mp3", "video": ""}, {"text": "Which of the following factors is not responsible for maintaining corneal transparency?", "options": [{"label": "A", "text": "Corneal Epithelium and Tear Film", "correct": false}, {"label": "B", "text": "Avascularity of the Cornea", "correct": false}, {"label": "C", "text": "Corneal nerve supply", "correct": true}, {"label": "D", "text": "Endothelial Pumps", "correct": false}], "correct_answer": "C. Corneal nerve supply", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ikDxt9JmAApD8Gv0Bk5y1746696366.mp3", "video": ""}, {"text": "Match the following corneal assessment techniques with their correct descriptions: 1) Keratometry a) Measures both anterior and posterior corneal surfaces. 2) Placido's Disc b) Assesses the smoothness and curvature of the corneal surface. 3) Corneal Topography c) Evaluate the anterior curvature of the cornea and generate colour-coded maps. 4) Corneal Tomography (Pentacam) d) Measures the curvature of the central cornea.", "options": [{"label": "A", "text": "1-a, 2-c, 3-d, 4-b", "correct": false}, {"label": "B", "text": "1-d, 2-b, 3-c, 4-a", "correct": true}, {"label": "C", "text": "1-d, 2-a, 3-b, 4-c", "correct": false}, {"label": "D", "text": "1-b, 2-a, 3-c, 4-d", "correct": false}], "correct_answer": "B. 1-d, 2-b, 3-c, 4-a", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/GbtpVnhiiknN7ulfqJZF1742990992.png", "https://image.prepladder.com/notes/0x7WdhAgJ4zJKB2611pD1742991011.png", "https://image.prepladder.com/notes/JWice7GDHn1Vummu47qT1742991030.png", "https://image.prepladder.com/notes/Uy91b12Jyol3po1eYEiD1742991053.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:628px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Instrument</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Image</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Keratometry:</strong></p>\n<ul>\n<li>An objective method for measuring the<strong> <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the central <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> </strong>to estimate corneal astigmatism.</li>\n<li><strong>Principle of Keratometer: </strong>Measures corneal <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> by <strong>analyzing the size of the image formed by the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> corneal surface, utilizing visible doubling.</strong></li>\n<li><strong>Normal Keratometric Values: </strong>\n<ul>\n<li>Average: <strong>45 D</strong></li>\n<li>Keratoconus &gt;45 D</li>\n</ul>\n</li>\n<li><strong>Types of Keratometers:</strong>\n<ul>\n<li><strong>Javal-Schiotz Model</strong></li>\n<li><strong>Bausch &amp; Lomb Model</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Auto Refractive Keratometer\" data-author=\"Mass Communication Specialist 2nd Class Jonathen E. Davis\" data-hash=\"1996\" data-license=\"Open access\" data-source=\"https://commons.wikimedia.org/wiki/File:US_Navy_101019-N-1531D-054_Air_Force_Master_Sgt._Breck_Downey_uses_a_auto-refractive_keratometer_to_determine_an_eye_prescription_during_a_Continui.jpg\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/GbtpVnhiiknN7ulfqJZF1742990992.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n\t\t\t \n\n\t\t\t<p style=\"text-align:center\"><strong>Auto <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> Keratometer</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Keratoscopy or placido's disc:</strong></p>\n<ul>\n<li>A disc with <span class=\"customMeta\" data-dictid=\"1b5a7ceea716927771815e7283e571\">alternating</span> black and white circles.</li>\n<li>Assesses the <strong>smoothness and <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the corneal surface</strong>.</li>\n<li><strong>Normal Observation:</strong> Uniform, sharp image of circles on the cornea.</li>\n<li><strong>Irregularities on cornea:</strong> Distort the circles</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Keratoscopy or placido's disc\" data-author=\"\" data-hash=\"1999\" data-license=\"\" data-source=\"\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/0x7WdhAgJ4zJKB2611pD1742991011.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corneal topography:</strong></p>\n<ul>\n<li>Evaluates the<strong> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> </strong>of the cornea.</li>\n<li>Generates <strong>colour-coded maps </strong>of the corneal surface's shape, curvature, and elevation.</li>\n<li>Diagnoses conditions like keratoconus.</li>\n<li>Assists in planning <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> surgeries.</li>\n<li><strong>Does not provide information about the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> corneal surface</strong>.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Corneal Topography\" data-author=\"Jason7825\" data-hash=\"2000\" data-license=\"Open Access\" data-source=\"Computerised Corneal Topography - Corneal topography - Wikipedia\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/JWice7GDHn1Vummu47qT1742991030.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corneal <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">tomography</span> (Pentacam):</strong></p>\n<ul>\n<li>Measures<strong> both <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> corneal surfaces.</strong></li>\n<li>Provides a three-dimensional view of corneal structure.</li>\n<li>Identifies <span class=\"customMeta\" data-dictid=\"4e02cdf6641692777199b3cc3b7237\">subclinical</span> keratoconus.</li>\n<li>Assesses candidates for keratorefractive surgery.</li>\n<li>Uses Scheimpflug <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> for high accuracy in corneal measurements.</li>\n<li>Valuable for <span class=\"customMeta\" data-dictid=\"e76ccaf0af1692777196a34b3fb8dc\">preoperative</span> evaluations and monitoring disease progression.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Corneal Tomography (Pentacam)\" data-author=\"DEXi\" data-hash=\"2001\" data-license=\"CC0 1.0\" data-source=\"Oculus Pentacam Corneal Eye Scan - Corneal topography - Wikipedia\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/Uy91b12Jyol3po1eYEiD1742991053.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dRbcUVtzXJ9icd18pNoy1746697351.mp3", "video": ""}, {"text": "Which of the following statements is false?", "options": [{"label": "A", "text": "Pachymetry measures corneal thickness and is used for diagnosing glaucoma", "correct": false}, {"label": "B", "text": "Specular Microscopy is used for photographing the corneal endothelium", "correct": false}, {"label": "C", "text": "Aesthesiometer measures corneal sensation and is used to assess neurotrophic keratitis", "correct": false}, {"label": "D", "text": "Aesthesiometer measures corneal sensation by evaluating the second cranial nerve", "correct": true}], "correct_answer": "D. Aesthesiometer measures corneal sensation by evaluating the second cranial nerve", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/yn30JY3WXp3lc2VZXHyG1742991366.png", "https://image.prepladder.com/notes/2jxCJVvFPO8RGRauDPlM1742991386.png", "https://image.prepladder.com/notes/mil0pyAJkp8w8FBHeEw01742991405.png", "https://image.prepladder.com/notes/KJN1WlOVtgh2nix3RZyH1742991425.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>INSTRUMENT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>IMAGE</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Pachymetry</u></strong></p>\n<ul>\n<li>Measures corneal thickness.</li>\n<li>Used for diagnosing and treating <strong>glaucoma</strong>. <strong>(Option A ruled out)</strong></li>\n<li>Assesses corneal <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> for <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors and <span class=\"customMeta\" data-dictid=\"9ea5f636c816927771915795d98ad0\">LASIK</span> surgery.</li>\n<li>Evaluate corneal diseases such as corneal hydrops, keratoconus, and Fuchs’ dystrophy.</li>\n<li>Monitors eye injuries.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Pachymeter\" data-author=\"ira tucker\" data-hash=\"2016\" data-license=\"CC BY-SA 2.0\" data-source=\"Pachymeter (by itucker at Flickr) - Corneal pachymetry - Wikipedia\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/yn30JY3WXp3lc2VZXHyG1742991366.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Specular Microscopy:</u></strong></p>\n<ul>\n<li>Noninvasive technique for photographing and assessing the corneal endothelium. <strong>(Option B ruled out)</strong></li>\n<li>Evaluates <span class=\"customMeta\" data-dictid=\"e76ccaf0af1692777196a34b3fb8dc\">preoperative</span> endothelial health before high-risk surgeries.</li>\n<li>Assesses the impact of lasers during <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> surgery.</li>\n<li><strong>Examines donor <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> before transplantation</strong>.</li>\n<li>Pathologies Assessed Include Fuchs endothelial dystrophy, corneal dystrophies, <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"83e71f714e1692777196e0d998ad3c\">polymorphous</span> dystrophy, <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> <span class=\"customMeta\" data-dictid=\"ee5175c06116927771880846d1cbe0\">hereditary</span> endothelial dystrophy, uveitis, <span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\">viral</span> endothelitis, pseudophakic bullous keratopathy, ICE syndrome, trauma, pharmacological disruptions.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<figure class=\"caption_element\"><img alt=\"Specular Microscope\" data-author=\"Nagatsuyu, Claudia &amp; Abreu, Priscila &amp; Kobashigawa, Karina &amp; Conceição, Luciano &amp; Morales, Adriana &amp; Andrade, Alexandre &amp; Padua, Ivan &amp; Martins, Bianca &amp; Laus, José.\" data-hash=\"2017\" data-license=\"CC BY -NC 4.0\" data-source=\"-Photographic images of non-contact specular microscopy (SP-3000P ®... | Download Scientific Diagram (researchgate.net)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/2jxCJVvFPO8RGRauDPlM1742991386.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Cornea on Specular Microscopy\" data-author=\"Professor Philippe Gain\" data-hash=\"2018\" data-license=\"CC BY SA 3.0\" data-source=\"File:Cornea endothelium specular.jpg - Wikimedia Commons\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/mil0pyAJkp8w8FBHeEw01742991405.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Esthesiometer (Aesthesiometer):</u></strong></p>\n<ul>\n<li>Measures <strong>corneal sensation</strong> (tactile sensation).</li>\n<li>Evaluates the <strong>ophthalmic branch of the fifth <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve</strong> (trigeminal nerve). <strong>(Option D ruled out)</strong></li>\n<li>Uses a cotton-tipped <span class=\"customMeta\" data-dictid=\"d92c980eca169277718111534b11c6\">applicator</span> for <span class=\"customMeta\" data-dictid=\"1304db17d3169277719684a316a8c4\">qualitative</span> testing.</li>\n<li>The handheld <span class=\"customMeta\" data-dictid=\"0e6c34004b1692777187acd454d135\">esthesiometer</span> (Cochet-Bonnet) features a retractable <span class=\"customMeta\" data-dictid=\"7d418b8fa91692777193a09dec2dca\">nylon</span> monofilament, adjustable up to 6 cm, with pressure increasing from 11 mm/gm to 200 mm/gm as the length decreases.</li>\n<li>Diagnoses <strong>neurotrophic keratitis</strong> and assesses corneal health in long-term <span class=\"customMeta\" data-dictid=\"b8a7f0f92a16927771853a60b379f8\">contact lens</span> wearers. <strong>(Option C ruled out)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Esthesiometer\" data-author=\"Spadea, Leopoldo &amp; Salvatore, Serena &amp; Vingolo, Enzo Maria.\" data-hash=\"2019\" data-license=\"CC BY\" data-source=\"The Cochet-Bonnet esthesiometer. | Download Scientific Diagram (researchgate.net)\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/KJN1WlOVtgh2nix3RZyH1742991425.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1gN3BmAMhOvBIGFOvqdi1746697627.mp3", "video": ""}, {"text": "A 32 y/o contact lens wearer presents with a red, painful eye, blurred vision, and increased sensitivity to light. Examination reveals lid swelling, conjunctival chemosis, and a large corneal ulcer with greenish exudate, rapidly expanding with hypopyon. What is the most likely cause?", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Streptococcus pneumoniae", "correct": false}, {"label": "C", "text": "Pseudomonas aeruginosa", "correct": true}, {"label": "D", "text": "Enterobacteriaceae", "correct": false}], "correct_answer": "C. Pseudomonas aeruginosa", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/sJU95DS6fWKkn0YVY0IQ1746698467.mp3", "video": ""}, {"text": "A 60 y/o woman presents with a painful red eye, photophobia, and a history of chronic use of corticosteroid eye drops. Examination reveals a corneal ulcer with necrosis extending deep into the corneal stroma, approaching Descemet's membrane. Which type of bacterial keratitis is this patient most at risk for?", "options": [{"label": "A", "text": "Localized Ulcer", "correct": false}, {"label": "B", "text": "Perforating Ulcer", "correct": true}, {"label": "C", "text": "Adherent Leucoma", "correct": false}, {"label": "D", "text": "Sloughing Ulcer", "correct": false}], "correct_answer": "B. Perforating Ulcer", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Localized Ulcer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Perforating Ulcer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Adherent Leucoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Sloughing Ulcer</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Begins with <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> of <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> cells.</li>\n<li>Leads to <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and <span class=\"customMeta\" data-dictid=\"1e7a15285e1692777198023b252c8c\">sloughing</span> of corneal tissue.</li>\n<li>Healing occurs with <strong>epithelialization and scarring.</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Deep <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> of <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> reaching Descemet's membrane.</strong></li>\n<li>Risk of <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> with any strain, leading to <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> complications.</li>\n<li>Small perforations opposite the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> may heal rapidly, forming an adherent leucoma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Occurs when a small <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> is plugged by the iris.</li>\n<li><strong>Results in <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> formation with permanent opacity.</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rapidly spreads across the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> due to<strong> <span class=\"customMeta\" data-dictid=\"417d56229b1692777202ce72999b28\">virulent</span> organisms or weak immunity</strong>.</li>\n<li>This leads to complete corneal destruction, <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> prolapse, and formation of an <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <strong>staphyloma with a pseudocornea.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DsKtcLQpFqcCIVwuQENA1746699453.mp3", "video": ""}, {"text": "Clinical question: Which of the following statements about the treatment of bacterial keratitis is incorrect?", "options": [{"label": "A", "text": "Cycloplegics like atropine can be used to reduce ciliary spasms and pain.", "correct": false}, {"label": "B", "text": "Ciprofloxacin (750mg twice daily) is given when the sclera gets involved.", "correct": false}, {"label": "C", "text": "Topical steroids should be started immediately to reduce inflammation.", "correct": true}, {"label": "D", "text": "Duo therapy with fortified cefazolin and tobramycin provides broad-spectrum coverage.", "correct": false}], "correct_answer": "C. Topical steroids should be started immediately to reduce inflammation.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DlDkWQ6uLZKgaD5UtmZy1746700115.mp3", "video": ""}, {"text": "What is the average thickness of the central cornea?", "options": [{"label": "A", "text": "1 to 1.2 mm", "correct": false}, {"label": "B", "text": "0.8 to 0.9 mm", "correct": false}, {"label": "C", "text": "0.5 to 0.6 mm", "correct": true}, {"label": "D", "text": "7.8 mm", "correct": false}], "correct_answer": "C. 0.5 to 0.6 mm", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:476px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>CORNEA</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diameter</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>11-11.7 mm</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Refractive Index</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1.376</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Refractive Power</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>45 Dioptre</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radius of curvature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior - 7.8mm <strong>(Option D ruled out)</strong></p>\n<p>Posterior - 6.5mm</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thickness at the centre</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0.5-0.6 mm (Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thickness at the periphery</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1-1.2 mm <strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/k9HRm4To9ckl2gtx6wyx1744876260.mp3", "video": ""}, {"text": "A 60 y/o man from a tropical region presents with a painful, red eye and a corneal ulcer following recent exposure to decaying vegetable matter. Which is the most common fungal infection affecting the cornea?", "options": [{"label": "A", "text": "Candida albicans", "correct": false}, {"label": "B", "text": "Fusarium", "correct": false}, {"label": "C", "text": "Mucormycosis", "correct": false}, {"label": "D", "text": "Aspergillus fumigatus", "correct": true}], "correct_answer": "D. Aspergillus fumigatus", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ljyXjFp30YrhagEVmaWz1746701246.mp3", "video": ""}, {"text": "A 45 y/o man from a tropical region presents with a painful red eye, significant watering, and sensitivity to light after working in a garden with decaying plant material. The patient is diagnosed with keratomycosis. Which of the following is not an examination finding in keratomycosis?", "options": [{"label": "A", "text": "Feathery extensions at the margins of the corneal ulcer", "correct": false}, {"label": "B", "text": "Extensive corneal vascularization", "correct": true}, {"label": "C", "text": "Sterile immune ring", "correct": false}, {"label": "D", "text": "Endothelial plaque", "correct": false}], "correct_answer": "B. Extensive corneal vascularization", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/yXRTYZeYlp9N7EfVmXKw1743053119.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>• Pain and foreign body sensation</p>\n<p>• Watering of the eye</p>\n<p>• Photophobia</p>\n<p>• Blurred vision</p>\n<p>• Redness</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Typical Examination Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>• <strong>Corneal Ulcer</strong>: Greyish-white, dry, with elevated rolled-out margins</p>\n<p>• <strong>Pigmented Ulcer</strong>: Seen with <span class=\"customMeta\" data-dictid=\"0f22e5402f16927771853bb4b7b234\">dematiaceous</span> fungi</p>\n<p>• <strong>Feathery Extensions</strong>: Branching extensions into surrounding stroma<strong> (Option A)</strong></p>\n<p>• <strong>Sterile Immune Ring</strong>: Immune complex deposition <strong>(Option C)</strong></p>\n<p>• <strong>Satellite Lesions</strong>: Small lesions near main ulcer</p>\n<p>• <strong>Hypopyon</strong>: Large, often non-sterile</p>\n<p>• <strong>Endothelial Plaque</strong>: Dense accumulation of <span class=\"customMeta\" data-dictid=\"18c2380be716927772020c9b2863de\">fibrin</span> and leukocytes beneath <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> <strong>(Option D)</strong></p>\n<p>• <strong>Corneal Vascularization</strong>: <strong>Absent</strong>, especially in early disease (<strong>Option B is not seen</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>• Rare corneal perforation</p>\n<p>• Potential <span class=\"customMeta\" data-dictid=\"3c305b384216927771969ca4166493\">progression</span> to endophthalmitis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Key Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>• <strong>Corneal Scraping</strong>: For smears and culture</p>\n<p>• <strong>KOH Mount</strong>: Septate hyphae (Aspergillus, Fusarium) or yeast-like cells (Candida)</p>\n<p>• <strong>Gram &amp; Giemsa Stains</strong>: Inflammatory cells and fungal elements</p>\n<p>• <strong>Culture</strong>: Sabouraud <span class=\"customMeta\" data-dictid=\"baf8b019b01692777186c856f83721\">dextrose</span> agar</p>\n<p>• <strong>PCR</strong>: For early <span class=\"customMeta\" data-dictid=\"ed4634701d16927771942c4408495f\">pathogen</span> detection</p>\n<p>• <strong>Confocal Microscopy</strong>: In vivo fungal visualization</p>\n<p>• <strong>Anterior Chamber Paracentesis / Biopsy</strong>: If needed for deeper infection</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jPXTzUJ0p0XL5n9eHHux1746454784.mp3", "video": ""}, {"text": "A 45 y/o male presents with redness, pain, and decreased vision in his right eye. He reports a history of trauma to the eye with a plant material three days ago. O/E, there is a corneal ulcer with feathery edges and satellite lesions. Hypopyon is also noted. Which of the following is the most appropriate initial treatment for this patient?", "options": [{"label": "A", "text": "Topical Moxifloxacin", "correct": false}, {"label": "B", "text": "Topical Natamycin", "correct": true}, {"label": "C", "text": "Oral Acyclovir", "correct": false}, {"label": "D", "text": "Intravitreal Amphotericin B", "correct": false}], "correct_answer": "B. Topical Natamycin", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>BACTERIAL KERATITIS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>FUNGAL KERATITIS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most common etiology</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>S. aureus (world)</p>\n<p>S. epidermidis (India)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aspergillus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>On examination</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fluorescein <span class=\"customMeta\" data-dictid=\"b29a1a16ab1692777199ede1c6e28b\">stain</span> positive ulcer</li>\n<li>Hypopyon (sterile)</li>\n<li>Stromal edema</li>\n<li>Descemet’s <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> folds</li>\n<li>Keratic precipitates due to <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Signs &gt;&gt;&gt; symptoms</li>\n<li>Dry/rough ulcer</li>\n<li>Has projecting ends</li>\n<li>Hypopyon (unsterile)</li>\n<li>Satellite nodules are <span class=\"customMeta\" data-dictid=\"802328b229169277719000601489eb\">infective</span> and have immune reaction</li>\n<li>Wessley ring</li>\n<li>IOP is high</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Empirical monotherapy: Moxifloxacin, gatifloxacin, besifloxacin</li>\n<li>Duo therapy: <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">Gram</span> positive + <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">gram</span> negative. Combination of <span class=\"customMeta\" data-dictid=\"74e05b271916927771848ff58d86f9\">Cefazolin</span> with <span class=\"customMeta\" data-dictid=\"ca244a562f16927771884ac81c7d2e\">Gentamicin</span> or <span class=\"customMeta\" data-dictid=\"ccdefe2f7e169277718419d6bb8958\">Cefuroxime</span> with Gentamicin.</li>\n<li>Cycloplegics and mydriatics</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Antifungals: <span class=\"customMeta\" data-dictid=\"80fb5c7ab816927771938ba348bdc1\">Natamycin</span> 5%, amphotericin B</li>\n<li>Steroids are contraindicated</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YnyaBA9KjlI1rVMUaogF1746702026.mp3", "video": ""}, {"text": "A 45 y/o patient presents with eye redness, excessive tearing, and sensitivity to light. O/E, you observe dendritic ulcers and decreased corneal sensation. Based on these findings, which is the most likely etiological agent responsible for the patient's condition?", "options": [{"label": "A", "text": "Adenovirus", "correct": false}, {"label": "B", "text": "Varicella Zoster Virus (VZV)", "correct": false}, {"label": "C", "text": "Herpes Simplex Virus (HSV)", "correct": true}, {"label": "D", "text": "Chlamydia trachomatis", "correct": false}], "correct_answer": "C. Herpes Simplex Virus (HSV)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/T9LumMm6wRINym4isejq1743053760.png", "https://image.prepladder.com/notes/xBRHZ4MKZuLESSMWVozz1743053844.png", "https://image.prepladder.com/notes/Kx3IxYhfQShlzr62Mhw61743053803.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5oEbeCka4kFQ8W4FLbrm1746766510.mp3", "video": ""}, {"text": "A 35 y/o patient presents with pain, redness, photophobia, and decreased vision in the right eye. Slit-lamp examination reveals a dendritic ulcer on the cornea. Which of the following is the most appropriate initial treatment for this patient?", "options": [{"label": "A", "text": "Topical steroids and antibiotics", "correct": false}, {"label": "B", "text": "Oral acyclovir and lubricants", "correct": false}, {"label": "C", "text": "Topical acyclovir and cycloplegics", "correct": true}, {"label": "D", "text": "Oral steroids and topical antibiotics", "correct": false}], "correct_answer": "C. Topical acyclovir and cycloplegics", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TkPDxzvuZ7SEYTATQH7a1746767134.mp3", "video": ""}, {"text": "A 50 y/o male presents with decreased vision, redness, and a dull sensation in his R/E. He has a history of trigeminal neuralgia for which he underwent a Gasserian ganglion block. O/E, there is decreased corneal sensation and epithelial desquamation. Which of the following is the most likely cause of his symptoms?", "options": [{"label": "A", "text": "Keratomalacia", "correct": false}, {"label": "B", "text": "Herpes Simplex Virus (HSV) Infection", "correct": false}, {"label": "C", "text": "Neurotrophic Keratopathy", "correct": true}, {"label": "D", "text": "Neuroparalytic Keratopathy", "correct": false}], "correct_answer": "C. Neurotrophic Keratopathy", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uxeQccGZ5pBLZr2c13rn1746767605.mp3", "video": ""}, {"text": "A 65 y/o woman presents with a painful rash on her forehead and eyelid. She also reports blurred vision and photophobia. O/E, she has conjunctivitis, punctate epithelial keratitis, and iridocyclitis. Which of the following is a chronic ocular complication she is at risk of developing?", "options": [{"label": "A", "text": "Episcleritis", "correct": false}, {"label": "B", "text": "Corneal Scarring", "correct": true}, {"label": "C", "text": "Conjunctivitis", "correct": false}, {"label": "D", "text": "Secondary Glaucoma", "correct": false}], "correct_answer": "B. Corneal Scarring", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/m1XQPJI3sSmAPQdPzPua1746768342.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 45 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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Conjunctival invasion making a flap over cornea", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/UN0nMO9miuExwvFWw9RN1747036490.png", "https://image.prepladder.com/content/L2TwxPDQzzct8uH8rDl71747036499.png", "https://image.prepladder.com/content/tz42Q2c1NagK5lGqIo8H1747036508.png", "https://image.prepladder.com/content/0yeBA7srm03MooaJmmpb1747036519.png", "https://image.prepladder.com/content/MTAXEOmFBRa4FDauCCBO1747036415.png"], "explanation": "<p>Correct Answer C - Conjunctival invasion making a &lt;span class=\"customMeta\" data-dictid=\"7eae099d8d1692777202469603e6ed\"&gt;flap&lt;/span&gt; over cornea</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pterygium/Surfer’s eye</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pterygium is a triangular encroachment of vascularized <span class=\"customMeta\" data-dictid=\"09e414c5a71692777188ef029aefe5\">granulation</span> tissue covered by <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> in the<strong> <span class=\"customMeta\" data-dictid=\"f2a86bcac91692777190f5db6b96ca\">interpalpebral</span> area</strong>.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jmvaras José Miguel Varas, MD\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://en.wikipedia.org/wiki/Pterygium#/media/File:Pterygium_Slitlamp.jpg\" data-tags=\"\" height=\"423\" src=\"https://image.prepladder.com/content/UN0nMO9miuExwvFWw9RN1747036490.png\" width=\"630\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Parts: Cap, head, neck, body</li>\n<li><strong>Degenerative </strong>process</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p><strong>Aetiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Common in dry, sunny climates with sandy soils</li>\n<li><strong>Ultraviolet light </strong>is a probable factor</li>\n<li>Usually elderly persons</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Pathology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Nephron\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://librepathology.org/wiki/File:Pterygium_-_high_mag.jpg\" data-tags=\"\" height=\"458\" src=\"https://image.prepladder.com/content/L2TwxPDQzzct8uH8rDl71747036499.png\" width=\"684\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p>Histology shows <strong>collagenous degenerative changes in the vascularized <span class=\"customMeta\" data-dictid=\"94aff4fd141692777199a78b5ed2eb\">subepithelial</span> stroma.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p><strong>Pathogenesis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Degenerative <span class=\"customMeta\" data-dictid=\"335f16a33c16927771992f5c55bc4d\">subconjunctival</span> proliferation</li>\n<li>Granulation tissue proliferates as avascularized tissue encroaches on the cornea.</li>\n<li>Destroys the <strong>superficial layers of the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> and Bowman’s membrane</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Frequently follows a pinguecula</li>\n<li>Often bilateral</li>\n<li>Usually on the <strong>nasal side</strong> <strong> </strong></li>\n<li>Impairment of vision due to:\n\t\t\t\t<ul>\n<li>Progression into the pupillary area of the cornea</li>\n<li>Induced <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> by corneal <span class=\"customMeta\" data-dictid=\"13d0edf82916927772021bfc7f9aeb\">flattening</span> in the <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> of pterygium</li>\n</ul>\n</li>\n<li><strong>Progressive </strong>pterygium: thick and vascular</li>\n<li><strong>Regressive </strong>pterygium: thin, pale, and atrophic</li>\n<li>Ceases to grow but never disappears</li>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the lesion</li>\n<li>Can present as <strong>inflammed pterygium</strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jonathan Trobe, M.D\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://en.wikipedia.org/wiki/Pterygium_(eye)#/media/File:Pterygium_(from_Michigan_Uni_site,_CC-BY).jpg\" data-tags=\"\" height=\"444\" src=\"https://image.prepladder.com/content/tz42Q2c1NagK5lGqIo8H1747036508.png\" width=\"583\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> cannot be passed under the lesion</li>\n<li><strong>Fusch’s spots/Islets of Vogt:</strong> small <span class=\"customMeta\" data-dictid=\"635650799116927771862d7cb568f4\">discrete</span> whitish flecks made of pterygial epithelial cells seen in progressive <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> and are also called the <strong>cap </strong>of the pterygium.</li>\n<li><strong>Stocker line: </strong>linear epithelial iron deposition, seen in <span class=\"customMeta\" data-dictid=\"531cf746021692777197c135fbce82\">regressive</span> pterygium.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Tae Seen Kang, Jong Joo Lee, Si Hwan Choi\" data-hash=\"\" data-license=\"CC BY NC 3.0\" data-source=\"https://www.researchgate.net/figure/Stockers-line-slit-lamp-photo-A-A-64-year-old-male-diagnosed-with-pteygium_fig2_304027779\" data-tags=\"\" height=\"357\" src=\"https://image.prepladder.com/content/0yeBA7srm03MooaJmmpb1747036519.png\" width=\"838\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p> </p>\n<p><strong>Management </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Best left alone</li>\n</ul>\n<p><strong>Medical treatment: </strong></p>\n<ul>\n<li>Tear substitutes for small <span class=\"customMeta\" data-dictid=\"531cf746021692777197c135fbce82\">regressive</span> <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> with dry eye</li>\n<li>Topical steroids for associated inflammation</li>\n<li>Protection from UV rays with sunglasses</li>\n</ul>\n<p><strong>Surgical <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> for:</strong></p>\n<ul>\n<li>Progression of <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> towards the pupillary area causing excessive <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> and visual impairment</li>\n<li>Restricted <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> movements</li>\n<li>Disfiguring</li>\n<li>Diplopia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p> </p>\n<p><strong>Procedures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Bare <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> technique:\n\t\t\t\t<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> is excised from the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and conjunctiva, leaving a bare sclera</li>\n<li>Associated with a high <span class=\"customMeta\" data-dictid=\"1d849ebc9b1692777197d4af1fa8d2\">recurrence</span> rate</li>\n</ul>\n</li>\n<li>Autoconjunctival graft\n\t\t\t\t<ul>\n<li>A piece of <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> conjunctival tissue from <strong>the same or the other eye </strong>or</li>\n<li>An<strong> <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> <span class=\"customMeta\" data-dictid=\"a283380a9a1692777188549537a964\">graft</span> </strong>is used to cover the bare sclera</li>\n<li>Sutured at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> to cover the defect</li>\n</ul>\n</li>\n<li>Surgical <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> with <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> <span class=\"customMeta\" data-dictid=\"8a6b591d1d16927771900a3c620d92\">keratectomy</span> and <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> for deeply infiltrating <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> recalcitrant pterygia</li>\n<li>Old methods (not used now):\n\t\t\t\t<ul>\n<li>McRaynold’s operation</li>\n<li>Postoperative use of <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">beta</span> irradiations</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p><strong>Post-operative therapy and care</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prevent recurrence:\n\t\t\t\t<ul>\n<li>Mitomycin C 0.02% drops</li>\n<li>Complications like scleral necrosis, cataracts, and <span class=\"customMeta\" data-dictid=\"0b673ec1e31692777190e88b9898af\">iritis</span> <strong> </strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pseudopterygium</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pterygium like lesion</li>\n<li>Due to cicatrizing conjunctival <strong>inflammatory </strong>overgrowth</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\" Facundo Urbinati, Davide Borroni, Marina Rodríguez-Calvo-de-Mora, José-María Sánchez-González, María García-Lorente, Francisco Zamorano-Martín, Rahul Rachwani-Anil, Santiago Ortiz-Pérez, Vito Romano and Carlos Rocha-de-Lossada \" data-hash=\"\" data-license=\"open access\" data-source=\"https://www.mdpi.com/2075-4418/12/8/1843\" data-tags=\"\" height=\"588\" src=\"https://image.prepladder.com/content/MTAXEOmFBRa4FDauCCBO1747036415.png\" width=\"712\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\"><strong>Aetiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Seen at any age</li>\n<li>Caused by\n\t\t\t\t<ul>\n<li>Trauma</li>\n<li>Chronic conjunctivitis</li>\n<li>Thermochemical burn</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"> </p>\n<p style=\"text-align:center\"><strong>Symptoms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Non-progressive</strong></li>\n<li>Can be at <strong>any quadrant</strong> of the corneal limbus</li>\n<li>Located away from the horizontal</li>\n<li>Attached to the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> due to <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> tissue</li>\n<li>Adhered to the adjacent lid</li>\n<li>Always <strong>stationary</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Signs </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> can be passed under the neck.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most probable diagnosis for a 23-year-old male who has been experiencing eye pain, sensitivity to light, and redness for the last two days, following an injury caused by brushing his eyes against leaves and thorns while gardening?", "options": [{"label": "A", "text": "Simplex keratitis", "correct": false}, {"label": "B", "text": "Bacterial keratitis", "correct": false}, {"label": "C", "text": "Fungal keratitis", "correct": true}, {"label": "D", "text": "Acanthamoeba keratitis", "correct": false}], "correct_answer": "C. Fungal keratitis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Causative organism: <strong>Aspergillus fumigatus</strong> &gt;&gt; Fusarium</li>\n<li>Predisposing factor: <strong>Vegetative matter injury</strong> (trauma) <strong>(Option C)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>SIGNS &gt;&gt; symptoms</strong></li>\n<li>Pain &amp; Foreign Body Sensation</li>\n<li>Watering/ Photophobia</li>\n<li>Blurred Vision, Redness</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Examination Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Corneal Ulcer:</strong> <strong>Greyish-white</strong>, dry, elevated, rolled-out margins</li>\n<li><strong>Pigmented Ulcer:</strong> Brownish, <span class=\"customMeta\" data-dictid=\"0f22e5402f16927771853bb4b7b234\">dematiaceous</span> fungi</li>\n<li><strong>Feathery Extensions:</strong> Finger-like projections in stroma</li>\n<li><strong>Sterile Immune Ring: </strong>Yellow line of demarcation</li>\n<li><strong>Satellite Lesions: </strong>Small lesions around the main ulcer</li>\n<li><strong>Hypopyon:</strong> <strong>Large, immobile, non-sterile</strong>, even in small ulcer</li>\n<li>Perforation: Rare but possible</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Corneal Scraping: For microbiological examination</li>\n<li><strong>Wet KOH Mount:</strong> <span class=\"customMeta\" data-dictid=\"c7247fbd3a1692777202a138609acb\">Filamentous</span> <span class=\"customMeta\" data-dictid=\"5ab0081e8316927772037e0f7c5a79\">fungi</span> or yeast-like <span class=\"customMeta\" data-dictid=\"5ab0081e8316927772037e0f7c5a79\">fungi</span> (Candida)</li>\n<li>Culture: <strong>Sabouraud's agar</strong> for fungal culture</li>\n<li>PCR: For rapid identification of pathogens</li>\n<li>Corneal Biopsy: For deep stromal <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> or negative cultures</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Topical <span class=\"customMeta\" data-dictid=\"c929a2b71516927771812a8b7b7ec3\">Antifungal</span> Agents:</strong> <strong>Natamycin 5%</strong>, Voriconazole, Amphotericin-B, Nystatin</li>\n<li><strong>Oral <span class=\"customMeta\" data-dictid=\"c929a2b71516927771812a8b7b7ec3\">Antifungal</span> Agents:</strong> Ketoconazole, <strong>Voriconazole</strong> (for severe ulcers)</li>\n<li><strong>Surgical Management:</strong>\n<ul>\n<li>Repeated Scraping: Removal of necrotic material</li>\n<li><strong>Cauterization Options:</strong> <span class=\"customMeta\" data-dictid=\"6d1f123ee21692777183f3fcf75999\">Carbolic acid</span> (100%), <span class=\"customMeta\" data-dictid=\"8c99460f21169277720025f264451b\">Trichloroacetic acid</span> (10%–20%), <span class=\"customMeta\" data-dictid=\"b9fa570d89169277719506ba2ad67e\">Povidone-iodine</span> (5%)</li>\n<li>Therapeutic Keratoplasty: Corneal transplantation</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>BACTERIAL <span class=\"customMeta\" data-dictid=\"f1711947d41692777190ce56ef2f7d\">KERATITIS</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>FUNGAL KERATITIS</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>S. aureus (worldwide)</li>\n<li>S. epidermidis (India)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Aspergillus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Examination Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Fluorescein <span class=\"customMeta\" data-dictid=\"b29a1a16ab1692777199ede1c6e28b\">stain</span> positive ulcer</li>\n<li><strong>Hypopyon (sterile)</strong></li>\n<li><strong>Stromal edema</strong></li>\n<li>Descemet’s <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> folds</li>\n<li>Keratic precipitates due to <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Signs &gt;&gt;&gt; symptoms</li>\n<li>Dry/rough ulcer</li>\n<li>Has projecting ends</li>\n<li><strong>Thick immobile unsterile hypopyon</strong></li>\n<li><strong>Satellite nodules</strong> are <span class=\"customMeta\" data-dictid=\"802328b229169277719000601489eb\">infective</span> and have immune reaction- <strong>Wessley ring</strong></li>\n<li>IOP is high</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Empirical monotherapy: Moxifloxacin, gatifloxacin, besifloxacin</li>\n<li>Duo therapy: <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">Gram</span> positive + <span class=\"customMeta\" data-dictid=\"f0347e3a7a1692777188cf90c50d6f\">gram</span> negative. Combination of <span class=\"customMeta\" data-dictid=\"74e05b271916927771848ff58d86f9\">Cefazolin</span> with <span class=\"customMeta\" data-dictid=\"ca244a562f16927771884ac81c7d2e\">Gentamicin</span> or <span class=\"customMeta\" data-dictid=\"ccdefe2f7e169277718419d6bb8958\">Cefuroxime</span> with Gentamicin.</li>\n<li>Cycloplegics and mydriatics</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Antifungals: <strong>Natamycin 5%</strong>, amphotericin B</li>\n<li>Steroids are contraindicated</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the image provided, which refractive error is observed in the depicted condition?", "options": [{"label": "A", "text": "Hypermetropia and astigmatism", "correct": false}, {"label": "B", "text": "Myopia and astigmatism", "correct": true}, {"label": "C", "text": "Myopia and hypermetropia", "correct": false}, {"label": "D", "text": "Hypermetropia", "correct": false}], "correct_answer": "B. Myopia and astigmatism", "question_images": ["https://image.prepladder.com/content/WctwV2IzTXfclEbD3l9U1746104349.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Progressive, non-inflammatory <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> ectatic corneal condition affecting the <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> part.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Involves progressive thinning and <span class=\"customMeta\" data-dictid=\"def85be6371692777186604c253b12\">ectasia</span> of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> due to <span class=\"customMeta\" data-dictid=\"144d78fe4816927771852de984c62f\">defective</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> of mucopolysaccharides and collagen.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Defective vision due to <strong>progressive <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> and <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> astigmatism</strong> (uncorrectable by glasses) <strong>(Option B)</strong></li>\n<li>Blurred and distorted vision, glare, and halos around lights</li>\n<li>Light sensitivity and <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> irritation</li>\n<li>Visual loss primarily from <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> and myopia, secondary loss from corneal scarring</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Examination Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Distorted Window Reflex:</strong> Visual <span class=\"customMeta\" data-dictid=\"01e6fc8ce01692777190444b00e46f\">irregularity</span> on corneal reflection.</li>\n<li>Placido Disc Irregularity: <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">Irregular</span> circles.</li>\n<li><strong>Slit-Lamp Examination:</strong>\n<ul>\n<li>Thinning and <span class=\"customMeta\" data-dictid=\"def85be6371692777186604c253b12\">ectasia</span> of the central cornea.</li>\n<li>Opacity at the apex, Fleischer Ring (brownish ring around the <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> due to haemosiderin in the epithelium).</li>\n<li>Folds in Descemet's and Bowman's membranes.</li>\n</ul>\n</li>\n<li><strong>Vogt Striae:</strong> Fine, <span class=\"customMeta\" data-dictid=\"635a7ea50e16927771944f08f17aed\">parallel</span> <span class=\"customMeta\" data-dictid=\"0509c7dd431692777199a912f7af7a\">striae</span> at the apex, disappearing with external pressure.</li>\n<li><strong>Oil Droplet Reflex: </strong>Annular dark shadow separating central and <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> in distant direct ophthalmoscopy.</li>\n<li>Retinoscopy: <strong>Yawning <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> (scissor reflex)</strong> with high oblique/irregular astigmatism.</li>\n<li>Ophthalmoscope Findings: <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">Irregular</span> <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> and progressive myopia, poorly corrected by <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> in later stages.</li>\n<li><strong>Munson's Sign: </strong>Localized bulging of the lower lid when looking down (seen in late stages).</li>\n<li>Keratometer Findings: Malformed, malaligned, and malfocused mires.</li>\n<li>Corneal Topography: Sensitive method for early detection, shows corneal surface shape.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Spectacle Correction:</strong></p>\n<ul>\n<li>Effective in the early stages, but contact lenses are more beneficial.</li>\n<li>Less effective in later stages due to <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> astigmatism.</li>\n</ul>\n<p><strong>Contact Lenses:</strong></p>\n<ul>\n<li>Rigid gas <span class=\"customMeta\" data-dictid=\"32343a48ea1692777195585b33c764\">permeable</span> lenses improve vision in early cases.</li>\n<li>Specially designed scleral lenses (e.g., Rose-K) are useful in early to moderate cases.</li>\n</ul>\n<p><strong>Corneal <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">Collagen</span> <span class=\"customMeta\" data-dictid=\"2cf4952c63169277718543a0883583\">Cross-Linking</span> (CXL):</strong></p>\n<ul>\n<li>New treatment <span class=\"customMeta\" data-dictid=\"2333eb40ca16927771925442e26719\">modality</span> to slow disease progression.</li>\n<li>Involves <strong>Riboflavin (0.1%) <span class=\"customMeta\" data-dictid=\"fe2c08a01b1692777187011e915049\">eye drops</span> and UVA radiation</strong>.</li>\n<li>Riboflavin induces <span class=\"customMeta\" data-dictid=\"2cf4952c63169277718543a0883583\">cross-linking</span> of corneal <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> to stabilize the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> and improve <span class=\"customMeta\" data-dictid=\"b8a7f0f92a16927771853a60b379f8\">contact lens</span> tolerance.</li>\n</ul>\n<p><strong>Keratoplasty :</strong></p>\n<ul>\n<li>Recommended if disease progresses or in cases of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"7b09c2b34916927771896ff30fcaa0\">hydrops</span> (Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> tear).</li>\n<li>Reserved for more advanced diseases or when other treatments fail.</li>\n<li>Penetrating <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> is common, but <strong>Deep Anterior Lamellar <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">Keratoplasty</span> (DALK)</strong> is preferred if Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> and <span class=\"customMeta\" data-dictid=\"b9a776cad316927771878445d3a99f\">endothelium</span> are intact, reducing <span class=\"customMeta\" data-dictid=\"49e378f9f71692777197bc5e458569\">rejection</span> risk.</li>\n</ul>\n<p><strong>Intracorneal Ring Segments (INTACS) :</strong></p>\n<ul>\n<li>Effective in early to moderate cases by <span class=\"customMeta\" data-dictid=\"13d0edf82916927772021bfc7f9aeb\">flattening</span> the cornea.</li>\n<li>Less effective in halting progression.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is incorrect regarding the corneal epithelium?", "options": [{"label": "A", "text": "Regeneration is limited to the limbus", "correct": false}, {"label": "B", "text": "Bowman’s membrane regenerates", "correct": true}, {"label": "C", "text": "Lined by stratified squamous epithelium", "correct": false}, {"label": "D", "text": "Apical cells have microvilli", "correct": false}], "correct_answer": "B. Bowman’s membrane regenerates", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/3BiOoI0TTFReodmZRsNU1745841378.png", "https://image.prepladder.com/content/xSy0P33eFIvXuxVNb4jK1745841384.png"], "explanation": "<p>Correct Answer B - Bowman’s &lt;span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\"&gt;membrane&lt;/span&gt; regenerates</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Layers of Cornea</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Epithelium</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The outermost layer comprises 5-6 layers of non-keratinized, <span class=\"customMeta\" data-dictid=\"e2f163c4cd1692777199def45e74f1\">stratified</span> <span class=\"customMeta\" data-dictid=\"5be0ee4ea316927771997104326685\">squamous</span> epithelial cells.<strong>(Option C ruled out)</strong></li>\n<li>Acts as a barrier, protecting the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and preventing tear fluid from entering the underlying stroma.</li>\n<li>Outermost layer Apical cells have <span class=\"customMeta\" data-dictid=\"4087852c1e1692777192e866353a05\">microvilli</span> to move the tear fluid.<strong>(Option D ruled out)</strong></li>\n<li>The <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> cells at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> are stem cells responsible for <strong>regenerating </strong>the corneal epithelium.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bowman’s Membrane</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Located just beneath the epithelium, this <span class=\"customMeta\" data-dictid=\"adb93c1540169277718043552b7de2\">acellular</span> layer is 12 µm thick and composed of densely packed <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> fibrils.</li>\n<li>It is a <span class=\"customMeta\" data-dictid=\"7958e897a6169277719621e27063ed\">protective barrier</span> to the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> but <strong>cannot regenerate</strong> <strong>(Option B) </strong>if damaged and heals by scarring.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Stroma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Making up about 90% of the cornea's <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> (approximately 0.5 mm thick), the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> consists of <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> fibrils arranged in <span class=\"customMeta\" data-dictid=\"635a7ea50e16927771944f08f17aed\">parallel</span> layers.</li>\n<li>These fibrils are embedded in a <span class=\"customMeta\" data-dictid=\"341e757ca9169277718922ba058b1d\">hydrated</span> <span class=\"customMeta\" data-dictid=\"14958c535b1692777192abd2a85abf\">matrix</span> of proteoglycans - <strong>Chondroitin and Keratan Sulphate </strong>(keratan sulphate maintains corneal transparency).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pre-Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> (Dua's Layer)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>This layer, discovered in 2013, is about 15 µm thick, acellular, and lies just above Descemet's membrane.</li>\n<li>It is strong and resistant to air penetration.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Descemet's Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"e901999ab1169277719729899ebdee\">robust</span> basement <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> of the <span class=\"customMeta\" data-dictid=\"8aa7d6c2901692777185d83f2308c8\">corneal endothelium</span> is made of <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> and glycoproteins.</li>\n<li>It is tense, but when torn, curls inwards on itself.</li>\n<li><strong>It can regenerate (Option A ruled out) </strong>if damaged and is resistant to trauma and <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> processes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Endothelium</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The innermost layer consists of a single layer of flat, hexagonal cells.</li>\n<li><strong>These cells are crucial for maintaining corneal transparency by regulating <span class=\"customMeta\" data-dictid=\"98d46770fc1692777202253fb59fe9\">fluid balance</span> within the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> through an active pump mechanism.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which layer is accountable for preserving the moisture and clarity of the cornea?", "options": [{"label": "A", "text": "Descemet’s membrane", "correct": false}, {"label": "B", "text": "Endothelium", "correct": true}, {"label": "C", "text": "Stroma", "correct": false}, {"label": "D", "text": "Corneal epithelium", "correct": false}], "correct_answer": "B. Endothelium", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/oekmmbLRiO3UVw5CO0Z21745238992.png", "https://image.prepladder.com/content/eCtQ2afUXPpA14jlzD3n1745238998.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Layers of Cornea</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Epithelium </strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The outermost layer comprises 5-6 layers of non-keratinized, <span class=\"customMeta\" data-dictid=\"e2f163c4cd1692777199def45e74f1\">stratified</span> <span class=\"customMeta\" data-dictid=\"5be0ee4ea316927771997104326685\">squamous</span> epithelial cells.</li>\n<li>Acts as a<strong> barrier</strong>, protecting the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and preventing tear fluid from entering the underlying stroma.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> cells at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> are stem cells responsible for <strong>regenerating </strong>the corneal epithelium.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bowman’s Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Located just beneath the epithelium, this <span class=\"customMeta\" data-dictid=\"adb93c1540169277718043552b7de2\">acellular</span> layer is 12 µm thick and composed of densely packed <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> fibrils.</li>\n<li>It is a <span class=\"customMeta\" data-dictid=\"7958e897a6169277719621e27063ed\">protective barrier</span> to the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> but cannot regenerate if damaged and heals by scarring.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stroma </strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Making up about 90% of the cornea's <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> (approximately 0.5 mm thick), the <span class=\"customMeta\" data-dictid=\"c077aecdcd1692777199503c836d9c\">stroma</span> consists of <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> fibrils arranged in <span class=\"customMeta\" data-dictid=\"635a7ea50e16927771944f08f17aed\">parallel</span> layers.</li>\n<li>These fibrils are embedded in a <span class=\"customMeta\" data-dictid=\"341e757ca9169277718922ba058b1d\">hydrated</span> <span class=\"customMeta\" data-dictid=\"14958c535b1692777192abd2a85abf\">matrix</span> of proteoglycans - <strong>Chondroitin and Keratan Sulphate </strong>(keratan sulphate maintains corneal transparency).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pre-Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> (Dua's Layer) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>This layer, discovered in 2013, is about 15 µm thick,<strong> acellular</strong>, and lies just above Descemet's membrane.</li>\n<li>It is strong and resistant to air penetration.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">Membrane</span> </strong><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"e901999ab1169277719729899ebdee\">robust</span> basement <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> of the <span class=\"customMeta\" data-dictid=\"8aa7d6c2901692777185d83f2308c8\">corneal endothelium</span> is made of <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> and glycoproteins.</li>\n<li>It is tense, but when torn, curls inwards on itself.</li>\n<li>It can regenerate if damaged and is resistant to trauma and <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> processes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Endothelium</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The innermost layer consists of a single layer of flat, hexagonal cells.</li>\n<li><strong>These cells are crucial for maintaining corneal transparency by regulating <span class=\"customMeta\" data-dictid=\"98d46770fc1692777202253fb59fe9\">fluid balance</span> within the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> through an active pump mechanism.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the distinguishing characteristic of a fungal ulcer?", "options": [{"label": "A", "text": "Hypopyon", "correct": false}, {"label": "B", "text": "Dendritic ulcer on a fluorescein dye", "correct": false}, {"label": "C", "text": "Ring abscess", "correct": false}, {"label": "D", "text": "Satellite lesion", "correct": true}], "correct_answer": "D. Satellite lesion", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/aI6Ob1W1Ia2goaX3plfK1745239154.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 64-year-old woman with a history of trauma to the left eye 5 days back now presented with complaints of complete loss of vision. Upon examination the following findings were seen. What should be the subsequent course of action to manage this condition?", "options": [{"label": "A", "text": "Keratoplasty", "correct": true}, {"label": "B", "text": "Keratotomy", "correct": false}, {"label": "C", "text": "LASIK", "correct": false}, {"label": "D", "text": "DCR", "correct": false}], "correct_answer": "A. Keratoplasty", "question_images": ["https://image.prepladder.com/content/gAyzXbnfFbTGKZu5aX031746699577.png"], "explanation_images": ["https://image.prepladder.com/content/ZsxRnF436vfu4icOduUm1746699680.png", "https://image.prepladder.com/content/Wo0UFTFEkWUBJIgq1Ls01746699684.png", "https://image.prepladder.com/content/UTY5p61TcjMGA5M3pDQ81746699690.png"], "explanation": "<p>Correct Option A - Keratoplasty</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n<p><strong>Optical</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Corneal opacity</li>\n<li>Bullous keratopathy</li>\n<li>Corneal dystrophies</li>\n<li>Advanced keratoconus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Therapeutic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>To replace an inflamed <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> that does not respond to conventional therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tectonic Graft</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>To restore the integrity of the eyeball, e.g., after corneal <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">perforation</span> <strong>(Option A)</strong> or in cases of significant corneal thinning.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cosmetic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>To improve the appearance of the eye</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which glycosaminoglycan is responsible for the transparency of the cornea?", "options": [{"label": "A", "text": "Keratan sulfate", "correct": true}, {"label": "B", "text": "Hyaluronic acid", "correct": false}, {"label": "C", "text": "Heparan sulfate", "correct": false}, {"label": "D", "text": "Dermatan sulfate", "correct": false}], "correct_answer": "A. Keratan sulfate", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Keratan sulfate</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mucopolysaccharide</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Primary Locations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Functions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hyaluronic Acid (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Connective tissues, tendons, <span class=\"customMeta\" data-dictid=\"d27f9c7a1b16927771999b1679d949\">synovial</span> fluid, <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> humor</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Serves as a <span class=\"customMeta\" data-dictid=\"ddc9f397e716927771916135359875\">lubricant</span> in joint cavities and contributes to the structure of <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissues</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Heparin (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Liver, lungs, spleen, monocytes</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Acts as an <span class=\"customMeta\" data-dictid=\"b5fc7729f316927771817f809648f5\">anticoagulant</span> by activating <span class=\"customMeta\" data-dictid=\"fa202015a216927771814a0dc268ba\">antithrombin</span> III, which inactivates <span class=\"customMeta\" data-dictid=\"ac7e1f394f1692777200c5bb11e4d8\">thrombin</span> and other <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> factors</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Chondroitin <span class=\"customMeta\" data-dictid=\"535af9a2181692777199309af44d24\">Sulfate</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cartilage, bone, tendons, cornea, skin</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Provides structural support to <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissues and contributes to their <span class=\"customMeta\" data-dictid=\"b11364e7ed169277719777251a2bfe\">resilience</span> and elasticity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Keratan <span class=\"customMeta\" data-dictid=\"535af9a2181692777199309af44d24\">Sulfate</span> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cornea, cartilage</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Dermatan <span class=\"customMeta\" data-dictid=\"535af9a2181692777199309af44d24\">Sulfate</span> (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Skin, blood vessels, heart valves</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Contributes to the structure of the skin, blood vessels, and heart valves</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a 30-year-old man who has a previous history of wearing contact lenses, and is currently experiencing pain, redness, and the presence of pus coming from his right eye? During examination, a greyish-white ulcer in the shape of a snake was observed on the lower portion of the cornea. Additionally, a hypopyon measuring 4 mm was found in the anterior chamber, along with a moderate flare reaction.", "options": [{"label": "A", "text": "Viral corneal ulcer", "correct": false}, {"label": "B", "text": "Bacterial corneal ulcer", "correct": true}, {"label": "C", "text": "Fungal corneal ulcer", "correct": false}, {"label": "D", "text": "Parasitic corneal ulcer", "correct": false}], "correct_answer": "B. Bacterial corneal ulcer", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Bacterial corneal u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient sustained blunt trauma to the eye 6 months ago and now presents with blurring of vision. What is the most likely condition?", "options": [{"label": "A", "text": "Iridodialysis", "correct": true}, {"label": "B", "text": "Ankyloblepharaon", "correct": false}, {"label": "C", "text": "Vossius Ring", "correct": false}, {"label": "D", "text": "Cycloiriditis", "correct": false}], "correct_answer": "A. Iridodialysis", "question_images": ["https://image.prepladder.com/content/pVvzA0zGY1D5e3eB5ph01741087416.png"], "explanation_images": ["https://image.prepladder.com/content/8EtAhjrEd0JW5mpqD8u41741087450.png", "https://image.prepladder.com/content/5dwlXBblN74zK1FKMSV71741087492.png", "https://image.prepladder.com/content/eujieKwkgl4nItjGZsvf1741087622.png", "https://image.prepladder.com/content/QdxXv5YiUwmvYhJUZScE1741087685.png", "https://image.prepladder.com/content/5DARlcpICbanYswk87eF1741087845.png", "https://image.prepladder.com/content/fwHl2jOWXhCZgieQbVEa1741087870.png", "https://image.prepladder.com/content/TKHDSUdG6TVeUTXga5oH1741087898.png", "https://image.prepladder.com/content/Ejz0G0GnGqtIBLQQELlf1741087953.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "For which of the subsequent diseases is collagen cross-linking therapy utilized?", "options": [{"label": "A", "text": "Keratoconus", "correct": true}, {"label": "B", "text": "Corneal ulcer", "correct": false}, {"label": "C", "text": "Band keratopathy", "correct": false}, {"label": "D", "text": "Uveitis", "correct": false}], "correct_answer": "A. Keratoconus", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Keratoconu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What's the main risk for a 37-year-old man with blurred vision and severe pain in his right eye? He revealed that recently, he went swimming in a pond. During examination, a ring-like lesion was found, as seen in the image.", "options": [{"label": "A", "text": "Diabetes", "correct": false}, {"label": "B", "text": "Hypertension", "correct": false}, {"label": "C", "text": "Steroids", "correct": false}, {"label": "D", "text": "Soft Contact lenses", "correct": true}], "correct_answer": "D. Soft Contact lenses", "question_images": ["https://image.prepladder.com/content/QwTVVUNE75sJ0cHpMwDU1747043234.png"], "explanation_images": [], "explanation": "<p>Correct Option D - Soft C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the diagnosis for a female patient, aged 65, who has a history of chickenpox and presents at the clinic with the following findings?", "options": [{"label": "A", "text": "Chicken pox exacerbation", "correct": false}, {"label": "B", "text": "Drug allergy to acyclovir", "correct": false}, {"label": "C", "text": "Herpes zoster ophthalmicus", "correct": true}, {"label": "D", "text": "Herpes zoster oticus", "correct": false}], "correct_answer": "C. Herpes zoster ophthalmicus", "question_images": ["https://image.prepladder.com/content/lyVqKf7UZVbDwoL7xVV81747043599.png"], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\"&gt;Herpes&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"03350c16f71692777202dbca70976e\"&gt;zoster&lt;/span&gt; ophthalmicu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Arlt’s line is seen in?", "options": [{"label": "A", "text": "Vernal keratoconjunctivitis", "correct": false}, {"label": "B", "text": "Phlyctenular keratoconjunctivitis", "correct": false}, {"label": "C", "text": "Trachoma", "correct": true}, {"label": "D", "text": "Pterygium", "correct": false}], "correct_answer": "C. Trachoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/qswSBCXGfd8LyAixvLh61747044246.png", "https://image.prepladder.com/content/sY3uY4JKZ7TuugtZMG6m1747044252.png", "https://image.prepladder.com/content/J5Yko4IzZcC98cs6Gjh61747044257.png", "https://image.prepladder.com/content/wSCAaEyHqEITTRZNBth41747044268.png", "https://image.prepladder.com/content/leYjdkN712YWsXEn3NCg1747044284.png", "https://image.prepladder.com/content/fiHOE0qmfSmhwXiTaItd1747044292.png", "https://image.prepladder.com/content/bdBhPTe53mj16IYi3wJy1747044302.png", "https://image.prepladder.com/content/qEtOPrcZZQ4yMhXtV2T51747044307.png", "https://image.prepladder.com/content/7ZFD57ZFxu1MPxfnRZLJ1747044312.png"], "explanation": "<p>Correct Option C - Trachoma</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Signs of active trachoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Signs of <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">cicatricial</span> trachoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li>Conjunctival congestion</li>\n<li>Follicles in the upper <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> conjunctiva: Look like sago-grains</li>\n<li>Papillary enlargement: red, velvety</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival signs:</strong></p>\n<ul>\n<li><strong>Scarring </strong>\n<ul>\n<li>It may be irregular, star-shaped, or linear</li>\n<li>Linear <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> in the <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> subtarsalis is called <strong>Arlt’s line (Option C) </strong></li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>accumulation of dead epithelial cells and <span class=\"customMeta\" data-dictid=\"11d92ee2d916927771907f5dfc40d1\">inspissated</span> <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> in the glands of Henle</li>\n<li>Pseudocyst</li>\n<li>Xerosis</li>\n<li>Symblepharon</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li>Superficial <span class=\"customMeta\" data-dictid=\"f1711947d41692777190ce56ef2f7d\">keratitis</span> on <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp and fluorescein</li>\n<li><strong>Herbert’s follicles </strong></li>\n<li><strong>Progressive </strong>pannus/<strong>Trachomatous pannus</strong>: The <strong>upper part of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is cloudy</strong></li>\n<li><strong>Corneal ulcers </strong>are common at the advancing edge of the pannus\n\t\t\t\t<ul>\n<li>Shallow, little infiltrated</li>\n<li>Cause <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> and photophobia</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Corneal signs:</strong></p>\n<ul>\n<li><strong>Regressive </strong>pannus or <strong>pannus siccus</strong>:\n\n\t\t\t\t<ul>\n<li>Receding infiltration</li>\n<li>Vessels extend beyond the area of <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> and haze</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Herbert pits</strong>: <span class=\"customMeta\" data-dictid=\"74793d564816927771943ae4ba74b3\">oval</span> or <span class=\"customMeta\" data-dictid=\"0919f0017e1692777184ac3748841f\">circular</span> pitted scars <strong>formed after the <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> of Herbert’s follicles in the <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> area</strong></li>\n<li>Vascularized and <strong>opaque cornea.</strong></li>\n<li>Corneal xerosis</li>\n<li>Corneal ectasia</li>\n<li>Total corneal <span class=\"customMeta\" data-dictid=\"388a4ccfbf1692777194a8f6a2d3b4\">pannus</span> (blinding sequelae)</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lid signs:</strong></p>\n<ul>\n<li>Distortion of the lids</li>\n<li><strong>Tylosis </strong>: Thickening of the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> plate/lid margin</li>\n<li><strong>Trichiasis </strong>due to <span class=\"customMeta\" data-dictid=\"97ae59957c1692777197359406f6f4\">rubbing</span> of lashes on the cornea</li>\n<li><strong>Trachomatous <span class=\"customMeta\" data-dictid=\"e18c2053271692777194e62a208e01\">ptosis</span> </strong>(sleepy appearance)</li>\n<li><strong>Entropion</strong></li>\n<li>Madarosis</li>\n<li>Ankyloblepharon</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lacrimal <span class=\"customMeta\" data-dictid=\"5a70fb96bf1692777181823f42fcf0\">apparatus</span> sequelae:</strong></p>\n<ul>\n<li>Chronic dacryocystitis</li>\n<li>Chronic dacryoadenitis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Active <span class=\"customMeta\" data-dictid=\"bc4fb02c561692777200c9effa5471\">Trachoma</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Diane K. Lavett, Van C Lansingh, Marissa J Carter, Kristen A Eckert, Juan Carlos Silva\" data-hash=\"\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Inflammatory-trachoma-with-Follicular-trachoma-TI-TF-stage-Figure-courtesy-of_fig6_237843559\" data-tags=\"\" height=\"258\" src=\"https://image.prepladder.com/content/qswSBCXGfd8LyAixvLh61747044246.png\" width=\"359\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\">Follicles in upper palpebral conjunctiva</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/Pannus-superior-limbus-with-Morgagnian-cataract.html#gsc.tab=0\" data-tags=\"\" height=\"188\" src=\"https://image.prepladder.com/content/sY3uY4JKZ7TuugtZMG6m1747044252.png\" width=\"345\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\">Trachomatous pannus</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"269\" src=\"https://image.prepladder.com/content/J5Yko4IzZcC98cs6Gjh61747044257.png\" width=\"269\"/></p>\n<p style=\"text-align:center\">Progressive pannus</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Cicatricial </strong></p>\n<p><strong>Trachoma </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Diane K. Lavett, Van C Lansingh, Marissa J Carter, Kristen A Eckert, Juan Carlos Silva\" data-hash=\"\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Trachomatous-scarring-TS-stage-Figure-courtesy-of-Hollman-Miller-Vaupes-Colombia_fig8_237843559\" data-tags=\"\" height=\"200\" src=\"https://image.prepladder.com/content/wSCAaEyHqEITTRZNBth41747044268.png\" width=\"359\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n\t\t\t<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Justin Risma, MD ,Stefani Karakas, CRA\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/herberts-pits.htm#gsc.tab=0\" data-tags=\"\" height=\"165\" src=\"https://image.prepladder.com/content/leYjdkN712YWsXEn3NCg1747044284.png\" width=\"345\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p> </p>\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"269\" src=\"https://image.prepladder.com/content/fiHOE0qmfSmhwXiTaItd1747044292.png\" width=\"269\"/></p>\n<p style=\"text-align:center\">Regressive pannus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"\" height=\"331\" src=\"https://image.prepladder.com/content/bdBhPTe53mj16IYi3wJy1747044302.png\" width=\"359\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\">Conjunctival concretions</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"\" height=\"227\" src=\"https://image.prepladder.com/content/qEtOPrcZZQ4yMhXtV2T51747044307.png\" width=\"345\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\">Trichiasis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"William Charles Caccamise, Sr, MD\" data-hash=\"\" data-license=\"CC BY NC ND\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma.html#gsc.tab=0\" data-tags=\"\" height=\"196\" src=\"https://image.prepladder.com/content/7ZFD57ZFxu1MPxfnRZLJ1747044312.png\" width=\"269\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\">Tylosis (thickening of <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> border of eyelid)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the main underlying factor responsible for regular astigmatism when studying the optics of a patient?", "options": [{"label": "A", "text": "Abnormal curvature of the cornea", "correct": true}, {"label": "B", "text": "Excessive eye rubbing", "correct": false}, {"label": "C", "text": "Prolonged exposure to bright light", "correct": false}, {"label": "D", "text": "Vitamin A deficiency", "correct": false}], "correct_answer": "A. Abnormal curvature of the cornea", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/L7UVwFLATO8W4CcAgEqS1747200091.png", "https://image.prepladder.com/content/1yZ6KUyDjoL3Z0K7e1MF1747200096.png", "https://image.prepladder.com/content/AcJ0ycvU8YrANZN0TceA1747200102.png", "https://image.prepladder.com/content/3MvWISMBvRGrSsPUbMp51747200125.png"], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\"&gt;Abnormal&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\"&gt;curvature&lt;/span&gt; of the cornea</p>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>With-the-Rule (WTR) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>The vertical <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> has greater <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> than the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> meridian.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Against-the-Rule (ATR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is more curved than the vertical meridian.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Oblique Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Principal meridians are at <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> angles (e.g., 45° and 135°), still perpendicular to each other.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bi-oblique Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Principal meridians are not perpendicular to each other (e.g., 30° and 100°).</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Simple Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>One <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> focuses on the retina; the other focuses in front (simple myopic) or behind (simple hypermetropic).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Compound Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Both meridians focus light either in front (compound myopic) or behind (compound hypermetropic) the retina.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mixed Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>One <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> focuses in front of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> (myopic), and the other behind (hypermetropic).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the screening test that is most sensitive for detecting vitamin A deficiency?", "options": [{"label": "A", "text": "Serum retinal &amp;lt;10 μg/decilitre", "correct": false}, {"label": "B", "text": "Beta carotene &amp;lt;50 μg/decilitre", "correct": false}, {"label": "C", "text": "Bitot spots", "correct": false}, {"label": "D", "text": "Night blindness", "correct": true}], "correct_answer": "D. Night blindness", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Arlt’s line is seen in which condition?", "options": [{"label": "A", "text": "Vernal keratoconjunctivitis", "correct": false}, {"label": "B", "text": "Phlyctenular conjunctivitis", "correct": false}, {"label": "C", "text": "Ophthalmia neonatorum", "correct": false}, {"label": "D", "text": "Trachoma", "correct": true}], "correct_answer": "D. Trachoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Trach\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male patient presents to the ophthalmology clinic with a history of eye trauma with vegetative material .He complains of severe eye pain, redness, tearing, and photophobia. Microscopic examination of the corneal scraping reveals septate hyphae at an acute angle. What is the most likely causative agent responsible for this condition?", "options": [{"label": "A", "text": "Fungal corneal ulcer", "correct": true}, {"label": "B", "text": "Bacterial corneal ulcer", "correct": false}, {"label": "C", "text": "Viral corneal ulcer", "correct": false}, {"label": "D", "text": "Acanthamoeba corneal ulcer", "correct": false}], "correct_answer": "A. Fungal corneal ulcer", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Fungal Corneal Ulcer \n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A corneal wisp test was performed, and the corneal reflex was elicited. Which of the following nerves is responsible for the afferent limb of this reflex?", "options": [{"label": "A", "text": "Facial Nerve", "correct": false}, {"label": "B", "text": "Trigeminal Nerve", "correct": true}, {"label": "C", "text": "Oculomotor Nerve", "correct": false}, {"label": "D", "text": "Abducens Nerve", "correct": false}], "correct_answer": "B. Trigeminal Nerve", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:629px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Reflex</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Afferent Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Efferent Nerve</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Accommodation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>II (Optic nerve)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>III (Oculomotor nerve)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Corneal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>V₁ (Ophthalmic, <span class=\"customMeta\" data-dictid=\"cdd6d30ff216927771933bc53be84b\">nasociliary</span> branch)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Bilateral VII (Facial nerve, <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> branch - orbicularis oculi)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cough</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>X (Vagus nerve)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>X (Vagus nerve, also <span class=\"customMeta\" data-dictid=\"80686f198416927771959402f37ba8\">phrenic</span> and <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> nerves)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Gag</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>IX (Glossopharyngeal nerve)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>X (Vagus nerve)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Jaw Jerk</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>V₃ (Mandibular branch, <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> from masseter)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>V₃ (Mandibular branch, motor to masseter)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Lacrimation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>V₁ (Ophthalmic branch) (loss of <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> does not preclude emotional tears)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>VII (Facial nerve)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Pupillary</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>II (Optic nerve)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>III (Oculomotor nerve)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with eyelid crusting and a thready sensation between the cornea and lids. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Chronic Blepharitis", "correct": true}, {"label": "B", "text": "Dry Eye Syndrome", "correct": false}, {"label": "C", "text": "Meibomian Gland Dysfunction", "correct": false}, {"label": "D", "text": "Conjunctivitis", "correct": false}], "correct_answer": "A. Chronic Blepharitis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic infection of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> part of the lid margin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Synonyms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> blepharitis</li>\n<li>Staphylococcal blepharitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causative Organisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Most commonly <span class=\"customMeta\" data-dictid=\"0520f732541692777199acffcfd9ba\">Staphylococci</span> (coagulase positive)</strong></li>\n<li>Rarely Streptococci, <span class=\"customMeta\" data-dictid=\"77ba04808316927771963f119df5a5\">Propionibacterium</span> acnes, and Moraxella</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic irritation</li>\n<li>Itching</li>\n<li>Mild lacrimation</li>\n<li>Gluing of cilia</li>\n<li>Mild photophobia</li>\n<li>Yellow crusts at the root of cilia</li>\n<li>Small ulcers that bleed easily when crusts are removed</li>\n<li>Red, thickened lid margins with dilated blood vessels</li>\n<li>Mild <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">papillary</span> <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> and conjunctival hyperemia</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lid Hygiene:\n\t\t\t\t<ul>\n<li>Warm compresses</li>\n<li>Cotton buds dipped in <span class=\"customMeta\" data-dictid=\"e63a499e5716927771860681cef17d\">dilute</span> baby shampoo or 3% sodium <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> solution</li>\n<li>Avoid touching</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Antibiotics</li>\n<li>Topical Steroids</li>\n<li>Ocular Lubricants</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with redness, extreme eye pain, and diminished vision. The patient frequently wears contact lenses. Which of the following organisms is most likely responsible for her condition?", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Streptococcus pyogenes", "correct": false}, {"label": "C", "text": "Acanthamoeba", "correct": true}, {"label": "D", "text": "Listeria", "correct": false}], "correct_answer": "C. Acanthamoeba", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C – Acanth\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Shield ulcer is seen in which of the following?", "options": [{"label": "A", "text": "Spring catarrh", "correct": false}, {"label": "B", "text": "Phlyctenular conjunctivitis", "correct": false}, {"label": "C", "text": "Atopic keratoconjunctivitis", "correct": true}, {"label": "D", "text": "Autoimmune Conditions", "correct": false}], "correct_answer": "C. Atopic keratoconjunctivitis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/BPAoDMZ3t23m8Aqhos2C1747655806.png", "https://image.prepladder.com/content/jFmZNwlBDa0EJAQZC4vl1747305846.png", "https://image.prepladder.com/content/5V8KoedgsbwriQ3utaPW1747305846.png", "https://image.prepladder.com/content/HVEcGc2MS7CcySdxr4aQ1747305846.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:686px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Vernal <span class=\"customMeta\" data-dictid=\"8b4e6e36bb169277719032f22681c2\">keratoconjunctivitis</span> or Spring catarrh</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p>It is a <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> that tends to occur with the onset of warm weather. It primarily affects young children and adolescents, particularly boys.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Course </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>The condition typically starts in childhood and may resolve on its own over 5–10 years.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Burning, Itching, Photophobia (sensitivity to light), and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> (excessive tearing).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Palpebral Form</strong>: Hypertrophied palpebral <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> with a cobblestone appearance; bluish-white color; dense <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> tissue with thickened epithelium.</li>\n<li><strong>Limbal </strong>or <strong>Bulbar Form</strong>: Opacification at the limbus, <span class=\"customMeta\" data-dictid=\"be6fe9c6c316927771889dbaaf2b89\">gelatinous</span> thickening, and Horner–Trantas dots</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Mucoid nodules and tranta dots\" data-author=\"DeGaulle I. Chigbu, Bisant A. Labib\" data-hash=\"12983\" data-license=\"CC BY 4.0\" data-source=\"https://www.mdpi.com/1424-8247/14/7/658\" data-tags=\"May2025\" height=\"222\" src=\"https://image.prepladder.com/notes/BPAoDMZ3t23m8Aqhos2C1747655806.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Pseudogerontoxon/cupid’s bow (which resembles <span class=\"customMeta\" data-dictid=\"e11c93da8d1692777182758f2163d6\">arcus</span> senilis) is a grayish-white ring at the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> seen in severe <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> <span class=\"customMeta\" data-dictid=\"b2a2e3ba5c1692777201528ac05837\">vernal</span> <span class=\"customMeta\" data-dictid=\"8b4e6e36bb169277719032f22681c2\">keratoconjunctivitis</span> (VKC).</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Seyfettin Erdem\" data-hash=\"\" data-license=\"CC BY NC 4.0\" data-source=\"https://www.researchgate.net/figure/Limbal-type-VKC-pseudogerontoxone-image-palpebral-papilla-64-patients-447-limbal_fig3_336972956\" data-tags=\"\" height=\"279\" src=\"https://image.prepladder.com/content/jFmZNwlBDa0EJAQZC4vl1747305846.png\" width=\"470\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<ul>\n<li><strong>Shield ulcers</strong> are a significant <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> of VKC, particularly in severe cases. These microerosions typically <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> on the upper third of the cornea.</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Yusuke Matsuzaki, Hiroshi Toshida, Toshihiko Ohta, Akira Murakami\" data-hash=\"\" data-license=\"CC BY\" data-source=\"https://www.researchgate.net/figure/Slitlamp-microscopic-image-of-a-25-year-old-man-showing-corneal-shield-ulcer-at-40-days_fig1_236941145\" data-tags=\"\" height=\"311\" src=\"https://image.prepladder.com/content/5V8KoedgsbwriQ3utaPW1747305846.png\" width=\"409\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<ul>\n<li><strong>Mixed form: </strong>Exhibits characteristics of both the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> (palpebral) and <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> subtypes, typically presenting in only one eye.</li>\n</ul>\n<p><strong>Maxwell Lyon's sign</strong> is a <span class=\"customMeta\" data-dictid=\"a952f661da169277719691c48c8cbe\">pseudomembrane</span> formed due to excessive <span class=\"customMeta\" data-dictid=\"ab75ea330616927771938a64f8ebd6\">mucus</span> deposition on the <span class=\"customMeta\" data-dictid=\"0a6b15e83616927771941190f46a83\">papilla</span> resulting in cobblestone papillae.</p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Alexandre Xavier Costa, José Álvaro Pereira Gomes, Leonardo Guedes Candido Marculino, Vera Lucia Liendo, Telma Pereira Barreiro, Myrna Serapião dos Santos\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Efficacy-of-supratarsal-triamcinolone-injection-after-1-week-on-the-upper-tarsal_fig1_318869687\" data-tags=\"\" height=\"312\" src=\"https://image.prepladder.com/content/HVEcGc2MS7CcySdxr4aQ1747305846.png\" width=\"390\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Histology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>In the palpebral form, <strong>hypertrophied </strong>papillae are observed, rich in eosinophils and other <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Topical therapy:</strong>\n<ul>\n<li>Antihistamines - Levocabastine &amp; emedastine</li>\n<li>Mast cell stabilizers - Sodium cromoglicate</li>\n<li>Mild steroids - Fluorometholone and <span class=\"customMeta\" data-dictid=\"1ef009aee816927771912e72480697\">loteprednol</span> etabonate,</li>\n<li>Acetylcysteine can control <span class=\"customMeta\" data-dictid=\"7a1ae24f701692777187a7f60bbd9f\">excess</span> mucus.</li>\n</ul>\n</li>\n<li><strong>Local therapy</strong>: Subtarsal <span class=\"customMeta\" data-dictid=\"a48ce797cd1692777199efc43b3e4c\">steroid</span> injections and <span class=\"customMeta\" data-dictid=\"7a2baeba7416927771858fcddc798f\">cryotherapy</span> for severe cases.</li>\n<li><strong>Surgical treatment: </strong>Excision of giant <span class=\"customMeta\" data-dictid=\"c948d4dca7169277719474a468ff5e\">papillae</span> and treatment of <span class=\"customMeta\" data-dictid=\"018fabee35169277719835cd1bf49c\">shield</span> ulcers with debridement and <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> or <span class=\"customMeta\" data-dictid=\"4f62176420169277718214bfcafae5\">bandage</span> contact lens.</li>\n<li>Cold compresses and tinted <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> for comfort.</li>\n<li>Avoid eye rubbing</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following layers is associated with the beaten bronze appearance?", "options": [{"label": "A", "text": "Endothelial Layer", "correct": true}, {"label": "B", "text": "Stroma", "correct": false}, {"label": "C", "text": "Sub-Epithelial Layer", "correct": false}, {"label": "D", "text": "Epithelial Layer", "correct": false}], "correct_answer": "A. Endothelial Layer", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/p94ZKjUyPE4bpQFRqQRy1747219196.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old male patient, who works in an iron factory, presents to the clinic with complaints of visual disturbances. He reports that his vision has been gradually worsening and he has noticed a change in the color perception. On examination, the ophthalmologist observes the presence of iron deposits in the eye. What is the most likely ocular condition responsible for the iron deposits in the eye and the patient's visual disturbances?", "options": [{"label": "A", "text": "Siderosis bulbi", "correct": true}, {"label": "B", "text": "Hemochromatosis", "correct": false}, {"label": "C", "text": "Retinitis pigmentosa", "correct": false}, {"label": "D", "text": "Age-related macular degeneration", "correct": false}], "correct_answer": "A. Siderosis bulbi", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"e4d583e26b1692777198454df4b41d\"&gt;Siderosis&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"7be1c27a4f16927771831ce746bc8e\"&gt;bulbi&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following combinations corresponds to the image given below?", "options": [{"label": "A", "text": "Cobalt blue- Tryptan blue - Corneal ulcer", "correct": false}, {"label": "B", "text": "Cobalt green- Rose bengal stain- Corneal ulcer", "correct": false}, {"label": "C", "text": "Cobalt blue- Fluorescein stain- Corneal ulcer", "correct": true}, {"label": "D", "text": "Cobalt blue- Lissamine green- Corneal ulcer", "correct": false}], "correct_answer": "C. Cobalt blue- Fluorescein stain- Corneal ulcer", "question_images": ["https://image.prepladder.com/content/yYtLleAR5zc2NcZFhzyJ1744974277.png"], "explanation_images": ["https://image.prepladder.com/content/2BkC34yjbLj8k7fmk6YC1744974323.png", "https://image.prepladder.com/content/lkKB2AE8Avnp7njuFYTl1744974323.png", "https://image.prepladder.com/content/lke527Bc17ebvnBwAJr71744974323.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The eye examination of a 20-year-old male shows a golden ring on the cornea. What of the following is the investigation of choice to diagnose the condition?", "options": [{"label": "A", "text": "Alpha-1-antitrypsin", "correct": false}, {"label": "B", "text": "Alpha-fetoprotein", "correct": false}, {"label": "C", "text": "Serum iron", "correct": false}, {"label": "D", "text": "Serum ceruloplasmin", "correct": true}], "correct_answer": "D. Serum ceruloplasmin", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What dye and filter are used in the image, as shown below?", "options": [{"label": "A", "text": "Lissamine dye green filter", "correct": false}, {"label": "B", "text": "Lissamine dye cobalt blue filter", "correct": false}, {"label": "C", "text": "Fluorescein dye green filter", "correct": false}, {"label": "D", "text": "Fluorescein dye cobalt blue filter", "correct": true}], "correct_answer": "D. Fluorescein dye cobalt blue filter", "question_images": ["https://image.prepladder.com/content/jNgnNpHvcMVWrsaLSYwY1745317963.png"], "explanation_images": ["https://image.prepladder.com/content/qmK6yIpcNCcDHOcMguK11745318011.png", "https://image.prepladder.com/content/3kT31MxflIc4zru7wcyP1745318019.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child with elevated liver enzymes presented to the OPD with the following eye finding on gonioscopy. It is associated with?", "options": [{"label": "A", "text": "Copper", "correct": true}, {"label": "B", "text": "Zinc", "correct": false}, {"label": "C", "text": "Selenium", "correct": false}, {"label": "D", "text": "Iron", "correct": false}], "correct_answer": "A. Copper", "question_images": ["https://image.prepladder.com/content/Sl4VxSbLGGMPqUDkPirt1746430953.png"], "explanation_images": [], "explanation": "<p>Correct Answer A - C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents to you with pain and redness in the right eye following an injury during welding. On examination, the image as seen below is observed. Which of the following is the appropriate next step in managing this patient?", "options": [{"label": "A", "text": "Steroids and antibiotics", "correct": false}, {"label": "B", "text": "Surgical exploration", "correct": false}, {"label": "C", "text": "Keratoplasty", "correct": false}, {"label": "D", "text": "Removal by 26G needle", "correct": true}], "correct_answer": "D. Removal by 26G needle", "question_images": ["https://image.prepladder.com/notes/9fTfwXE3BalDKWfLKLmL1747393919.png"], "explanation_images": [], "explanation": "<p>Correct Answer D - Removal by 26G\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the subsequent options does not exhibit a characteristic of keratoconus?", "options": [{"label": "A", "text": "Haab's striae", "correct": true}, {"label": "B", "text": "Munson's sign", "correct": false}, {"label": "C", "text": "Irregular astigmatism", "correct": false}, {"label": "D", "text": "Scissoring reflex", "correct": false}], "correct_answer": "A. Haab's striae", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/l8046fFHSsW16Iok3Ee41745322003.png", "https://image.prepladder.com/notes/hNLak445HBl884tEb9xN1745322110.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 30 year old man presents with a history of injury to the eye caused by a leaf 5 days ago, resulting in pain, photophobia, and redness of the eye for 2 days . Upon examination, corneal ulcer with feathery ends and satellite lesions around it are seen. What would be the most likely diagnosis?", "options": [{"label": "A", "text": "Anterior uveitis", "correct": false}, {"label": "B", "text": "Conjunctivitis", "correct": false}, {"label": "C", "text": "Fungal corneal ulcer", "correct": true}, {"label": "D", "text": "HSV corneal ulcer", "correct": false}], "correct_answer": "C. Fungal corneal ulcer", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Fungal corneal u\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacterial Corneal Ulcer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fungal Corneal Ulcer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Viral Corneal Ulcer</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Causative Agents</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bacteria (e.g., <span class=\"customMeta\" data-dictid=\"71c203268816927771994a1fffd645\">Staphylococcus</span> aureus, <span class=\"customMeta\" data-dictid=\"9562e26acc16927771995a2028dd05\">Streptococcus</span> pneumoniae)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fungi (e.g., Aspergillus, Fusarium)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Herpes simplex virus (HSV), Varicella-zoster virus (VZV)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clinical Features</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Redness, pain, <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> (mucopurulent), blurred vision, corneal <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> and <span class=\"customMeta\" data-dictid=\"fc3d080799169277719904701c07f9\">sterile</span> hypopyon.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dry/rough white or grayish-white <span class=\"customMeta\" data-dictid=\"7b4370a0b01692777201a5bc0739c2\">ulcer</span> with feathery edges, satellite nodules and an unsterile hypopyon.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dendritic (branching) pattern on <span class=\"customMeta\" data-dictid=\"468accc4d3169277720252132f5b85\">fluorescein</span> staining, foreign body sensation, tearing, photophobia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk Factors</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trauma, <span class=\"customMeta\" data-dictid=\"b8a7f0f92a16927771853a60b379f8\">contact lens</span> wear, <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> surface disease, recent <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> surgery</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prolonged <span class=\"customMeta\" data-dictid=\"a3e96d80e9169277718551158bbcd4\">corticosteroid</span> use, immunosuppression, <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> trauma or injury with plant material or contaminated objects</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prior history of <span class=\"customMeta\" data-dictid=\"f17a671af3169277718889c787fa9c\">herpetic</span> infection, immunosuppression, stress, decreased immune function</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Assertion: Topical steroids should not be used in the treatment of viral corneal ulcers. Reason: Topical steroids can cause increased intraocular pressure What is the correct option ?", "options": [{"label": "A", "text": "Both assertion and reasoning are correct and reason is the correct explanation of the assertion", "correct": false}, {"label": "B", "text": "Both assertion and reasoning are independently correct and reason is not correct explanation of the assertion", "correct": true}, {"label": "C", "text": "Assertion is independently a correct statement, but the reason is false", "correct": false}, {"label": "D", "text": "Both assertion and reason are false", "correct": false}], "correct_answer": "B. Both assertion and reasoning are independently correct and reason is not correct explanation of the assertion", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Both assertion and reasoning are independently correct and reason is not correct explanation of th\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the adjuvant therapy in fungal corneal ulcer?", "options": [{"label": "A", "text": "Pilocarpine eye drops", "correct": false}, {"label": "B", "text": "Lignocaine eye drops", "correct": false}, {"label": "C", "text": "Dexamethasone eye drops", "correct": false}, {"label": "D", "text": "Atropine Sulfate eye ointment", "correct": true}], "correct_answer": "D. Atropine Sulfate eye ointment", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the origin of corneal endothelium ?", "options": [{"label": "A", "text": "Neuroectoderm", "correct": false}, {"label": "B", "text": "Neural crest cells", "correct": true}, {"label": "C", "text": "Mesoderm", "correct": false}, {"label": "D", "text": "Surface ectoderm", "correct": false}], "correct_answer": "B. Neural crest cells", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\"&gt;Neural&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"48528974ed1692777185cd29753db5\"&gt;crest&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is contraindicated in infectious keratitis?", "options": [{"label": "A", "text": "Tear drops", "correct": false}, {"label": "B", "text": "Steroids", "correct": true}, {"label": "C", "text": "Cycloplegics", "correct": false}, {"label": "D", "text": "Timolol", "correct": false}], "correct_answer": "B. Steroids", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - S\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The following image shows :", "options": [{"label": "A", "text": "Bacterial keratitis", "correct": false}, {"label": "B", "text": "Fungal keratitis", "correct": false}, {"label": "C", "text": "Viral keratitis", "correct": true}, {"label": "D", "text": "Syphilitic keratitis", "correct": false}], "correct_answer": "C. Viral keratitis", "question_images": ["https://image.prepladder.com/content/OvgnPrsukH0SzOsaMmfU1691411538.png"], "explanation_images": [], "explanation": "<p>Correct Option C - Viral k\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 20-year-old male presents with recurrent fluctuations in his vision prescription . What is the probable diagnosis?", "options": [{"label": "A", "text": "Keratoconus", "correct": true}, {"label": "B", "text": "Pathological myopia", "correct": false}, {"label": "C", "text": "Glaucoma", "correct": false}, {"label": "D", "text": "Cataract", "correct": false}], "correct_answer": "A. Keratoconus", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Keratoconu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Fleischer’s ring is seen in", "options": [{"label": "A", "text": "Keratoconus", "correct": true}, {"label": "B", "text": "Keratomalacia", "correct": false}, {"label": "C", "text": "Keratoglobus", "correct": false}, {"label": "D", "text": "Trachoma", "correct": false}], "correct_answer": "A. Keratoconus", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/1a7SV43VbIfSENjKrDUR1714122467.png"], "explanation": "<p>Correct Option A - Keratoconu\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eye Ring</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Associated Condition</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fleischer's Ring</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Base of the cornea</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Keratoconus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Kayser-Fleischer Ring</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Descemet's membrane, corneal edge</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Wilson's disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hudson-Stahli Line</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cornea central third</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Aging</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vogt's Striae</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Deep corneal stroma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Keratoconus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Haab's Striae</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Descemet's membrane</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Congenital glaucoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stocker's Line</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior to head of pterygiumInner surface of the lens</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PterygiumNuclear <span class=\"customMeta\" data-dictid=\"dae4dea0581692777198fdef9fa684\">sclerosis</span> of the lens (cataract)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hassall-Henle Bodies</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior lens capsule</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal aging</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fleischer's Ring</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limbal area</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pterygium</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limbal Ring</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Outer edge of the iris</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal variation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Keratometer is used to assess", "options": [{"label": "A", "text": "Curvature of cornea", "correct": true}, {"label": "B", "text": "Diameter of cornea", "correct": false}, {"label": "C", "text": "Thickness of cornea", "correct": false}, {"label": "D", "text": "Curvature of lens", "correct": false}], "correct_answer": "A. Curvature of cornea", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\"&gt;Curvature&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the diagnosis ?", "options": [{"label": "A", "text": "Anterior uveitis", "correct": false}, {"label": "B", "text": "Glaucoma", "correct": false}, {"label": "C", "text": "Optic neuritis", "correct": false}, {"label": "D", "text": "Keratoconus", "correct": true}], "correct_answer": "D. Keratoconus", "question_images": ["https://image.prepladder.com/content/z20cJ6fQrzN1fIa1V0j91695202654.png"], "explanation_images": ["https://image.prepladder.com/content/Qv1Rky5nOXnwGhczCZcn1714117936.png", "https://image.prepladder.com/content/LKfCAi3fVOUDg7uc0Xb41714117936.png", "https://image.prepladder.com/content/MfjYWwdweSUc7w9yEKs01714117936.png", "https://image.prepladder.com/content/z6Xp8rLrZmLB5GxpFgUt1714117936.png"], "explanation": "<p>Correct Option D - Keratoconu\n<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Signs of keratoconus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Early signs</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>High <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> /asymmetric astigmatism</li>\n<li>Scissor’s <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on retinoscopy</li>\n<li>Fleischer's ring</li>\n</ul>\n<p><img src=\"https://image.prepladder.com/content/Qv1Rky5nOXnwGhczCZcn1714117936.png\" style=\"height:241px; width:336px\"/></p>\n<ul>\n<li>Vogt's striae</li>\n</ul>\n<p><img src=\"https://image.prepladder.com/content/LKfCAi3fVOUDg7uc0Xb41714117936.png\" style=\"height:314px; width:513px\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Late signs</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Munson's sign: Lower lid notching on down gaze</li>\n<li>Acute hydrops</li>\n</ul>\n<p><img src=\"https://image.prepladder.com/content/MfjYWwdweSUc7w9yEKs01714117936.png\" style=\"height:303px; width:478px\"/></p>\n<ul>\n<li>Prominent corneal nerves (due to corneal thinning)</li>\n</ul>\n<p><img src=\"https://image.prepladder.com/content/z6Xp8rLrZmLB5GxpFgUt1714117936.png\" style=\"height:280px; width:378px\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please analyze the image provided and determine the specific abnormality or injury present .", "options": [{"label": "A", "text": "Viral keratitis", "correct": true}, {"label": "B", "text": "Fungal keratitis", "correct": false}, {"label": "C", "text": "Bacterial keratitis", "correct": false}, {"label": "D", "text": "Interstitial keratitis", "correct": false}], "correct_answer": "A. Viral keratitis", "question_images": ["https://image.prepladder.com/content/w98WUHsAweYRUI89M5TG1691233680.png"], "explanation_images": ["https://image.prepladder.com/content/w98WUHsAweYRUI89M5TG1691233680.png"], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"5cc2d9fac616927772021889ee6d52\"&gt;Viral&lt;/span&gt; k\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely reason for a 21-year-old student to have ocular redness, feeling of a foreign object in the eye, and excessive tearing after wearing a soft contact lens, as indicated by the corneal scraping interface contrast microscopy image?", "options": [{"label": "A", "text": "Acanthamoeba", "correct": true}, {"label": "B", "text": "Naegleria fowleri", "correct": false}, {"label": "C", "text": "Entamoeba histolytica", "correct": false}, {"label": "D", "text": "Balamuthia mandrillaris", "correct": false}], "correct_answer": "A. Acanthamoeba", "question_images": ["https://image.prepladder.com/content/BFCllsbCRFBse9IfPGcz1715249250.JPG"], "explanation_images": [], "explanation": "<p>Correct Option A - Acanth\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a 27-year-old male patient who experiences eye trauma from vegetative matter, and currently exhibits symptoms including a corneal ulcer, hypopyon, satellite lesions, mild pain, photophobia, and redness?", "options": [{"label": "A", "text": "Fungal keratitis", "correct": true}, {"label": "B", "text": "Acanthamoeba keratitis", "correct": false}, {"label": "C", "text": "Viral keratitis", "correct": false}, {"label": "D", "text": "Bacterial keratitis", "correct": false}], "correct_answer": "A. Fungal keratitis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Fungal k\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 53 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Match the images of IOL malpositions with their names: Image Syndrome a. 1. Sunrise syndrome b. 2. Lost lens syndrome c. 3. Sunset syndrome", "options": [{"label": "A", "text": "a-1,b-2,c-3", "correct": false}, {"label": "B", "text": "a-3,b-1,c-2", "correct": true}, {"label": "C", "text": "a-2,b-1,c-3", "correct": false}, {"label": "D", "text": "a-1,b-3,c-2", "correct": false}], "correct_answer": "B. a-3,b-1,c-2", "question_images": ["https://image.prepladder.com/notes/m46C1lkWMDEpsoBlCMig1743624573.png", "https://image.prepladder.com/notes/J1FkZLqaeL6VP05nK8hM1743624622.png", "https://image.prepladder.com/notes/ew29Do0FMjwI64M5mEP81743624707.png"], "explanation_images": ["https://image.prepladder.com/notes/m46C1lkWMDEpsoBlCMig1743624573.png", "https://image.prepladder.com/notes/J1FkZLqaeL6VP05nK8hM1743624622.png", "https://image.prepladder.com/notes/ew29Do0FMjwI64M5mEP81743624707.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Name </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Malposition</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sunset syndrome</p>\n<p><img alt=\"OP052\" data-author=\"\" data-hash=\"6726\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/m46C1lkWMDEpsoBlCMig1743624573.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inferior <span class=\"customMeta\" data-dictid=\"e53b153fb316927771996481a3e88f\">subluxation</span> of IOL</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sunrise syndrome</p>\n<p><img alt=\"OP053\" data-author=\"\" data-hash=\"6727\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/J1FkZLqaeL6VP05nK8hM1743624622.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior <span class=\"customMeta\" data-dictid=\"e53b153fb316927771996481a3e88f\">subluxation</span> of IOL</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lost lens syndrome</p>\n<p><img alt=\"OP054\" data-author=\"\" data-hash=\"6728\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ew29Do0FMjwI64M5mEP81743624707.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Complete <span class=\"customMeta\" data-dictid=\"c1aae6e67f169277718624a4e51cfe\">dislocation</span> of an <span class=\"customMeta\" data-dictid=\"ffac6924ab16927771907dbb6fd7dd\">IOL</span> into the <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> cavity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Windshield wiper syndrome</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>When a very small <span class=\"customMeta\" data-dictid=\"ffac6924ab16927771907dbb6fd7dd\">IOL</span> is placed vertically in the <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> the superior loop moves to the left and right, with movements of the head</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3zlPctIKE2Ox0C018Zf31744956890.mp3", "video": ""}, {"text": "Toric IOLs are specifically designed to correct which type of refractive error?", "options": [{"label": "A", "text": "Myopia", "correct": false}, {"label": "B", "text": "Hypermetropia", "correct": false}, {"label": "C", "text": "Astigmatism", "correct": true}, {"label": "D", "text": "Presbyopia", "correct": false}], "correct_answer": "C. Astigmatism", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Y4h7jWzmvMG8B2gebe7Y1743622764.png", "https://image.prepladder.com/notes/HYtJrK3b2zRL9iqFzcuu1743622802.png", "https://image.prepladder.com/notes/BqZhoCYWGW7kAQ4E8TS01743623057.png", "https://image.prepladder.com/notes/xMDNaf1VNoFLwWzpBp2g1743623307.png", "https://image.prepladder.com/notes/O1RFkNJVV5LuwnDWZvoH1743623080.png", "https://image.prepladder.com/notes/6Y2zuUkVldFbV3wi7IUh1743623497.png", "https://image.prepladder.com/notes/yDvNdZogDSDcYdWMsZi71743623538.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:664px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior chamber IOL</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Iris supported lens</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lenses which lie completely in front of <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> and are supported in the angle of <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber. (S shaped haptic)</li>\n<li>Presently, AC-IOL are used in those cases where it is not possible to use PC-IOL (made of PMMA)</li>\n<li>Eg - <strong>Kelman multiflex</strong></li>\n</ul>\n<p><img alt=\"OP041\" data-author=\"\" data-hash=\"6644\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Y4h7jWzmvMG8B2gebe7Y1743622764.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lenses are fixed on the Iris, with the help of suture,claws or loops.</li>\n<li>They have high incidents of post-operative complications.</li>\n<li>Eg - <strong>Singh and Worst’s <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">Iris</span> <span class=\"customMeta\" data-dictid=\"c2193cdaa816927771843863690961\">claw</span> lens</strong></li>\n</ul>\n<p><img alt=\"OP042\" data-author=\"\" data-hash=\"6647\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/HYtJrK3b2zRL9iqFzcuu1743622802.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior chamber IOL</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scleral fixated IOL (SFIOL)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>PC-IOL can rest in <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> sulcus.</li>\n<li>Capsular bag <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> of PCIOL is the most ideal method.</li>\n<li>Eg - <strong>C loop type and four loop type.</strong></li>\n</ul>\n<p><img alt=\"OP043\" data-author=\"\" data-hash=\"6660\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/BqZhoCYWGW7kAQ4E8TS01743623057.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>They are preferred in cases of <span class=\"customMeta\" data-dictid=\"90d1792ffd1692777186055806b5ce\">ectopia</span> lentis and inadequate capsular support.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> of the IOL is placed in the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> chamber.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"7b2ff2c43e1692777188c39d49b162\">haptic</span> is fixed to the <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> approximately 1.5 to 2 mm from the limbus.</li>\n<li>SFIOL can be performed either with sutures or in a sutureless manner <strong>(Yamane technique).</strong></li>\n</ul>\n<br/>\n<img alt=\"OP068\" data-author=\"\" data-hash=\"6674\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/xMDNaf1VNoFLwWzpBp2g1743623307.png\"/></td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:555px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Special function IOL</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Toric IOL: Designed to correct <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> (Option C)</strong></li>\n<li><strong>Aspheric IOL: </strong>Designed to reduce spherical aberrations</li>\n<li><strong>Aniridia IOL: </strong>Designed to cover defects of <span class=\"customMeta\" data-dictid=\"6f7ae5c0d01692777181fda74da32a\">aniridia</span> or partial <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> loss.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:675px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unifocal IOLs</strong> are the most commonly used ones having <span class=\"customMeta\" data-dictid=\"91d92cc1301692777201bf14893200\">unifocal</span> power. Depending upon the power of IOLs implanted, these can make the patient emmetropic, myopic or hypermetropic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP044\" data-author=\"\" data-hash=\"6663\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/O1RFkNJVV5LuwnDWZvoH1743623080.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Multifocal lOLs</strong> have separate <span class=\"customMeta\" data-dictid=\"c96ea104c316927771941ae2b25704\">optics</span> to focus for distance and near, so also known as simultaneous vision lenses. These are of 2 types, either <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> or diffractive <span class=\"customMeta\" data-dictid=\"c96ea104c316927771941ae2b25704\">optics</span> types. These are also called pseudo <span class=\"customMeta\" data-dictid=\"2356f367651692777180439f6532bd\">accommodative</span> IOLs.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP045\" data-author=\"\" data-hash=\"6683\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/6Y2zuUkVldFbV3wi7IUh1743623497.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Accommodative IOLs</strong> exhibit some <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> movement of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> to improve the near vision. Available models of <span class=\"customMeta\" data-dictid=\"2356f367651692777180439f6532bd\">accommodative</span> IOLs are: Crystalens and Synchrony lens</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP045\" data-author=\"\" data-hash=\"6688\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/yDvNdZogDSDcYdWMsZi71743623538.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Extended-depth-of-Focus IOL-</strong> e.g. Technis Symphony, provides uncorrected distance, <span class=\"customMeta\" data-dictid=\"cf8f491dba169277719075ce2b5594\">intermediate</span> as well as near vision to some extent due to its elongated focus.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lI3UIas5qL6UnOijdPTV1744901167.mp3", "video": ""}, {"text": "Which of the following is considered the best formula for intraocular lens (IOL) power calculation after LASIK surgery?", "options": [{"label": "A", "text": "SRK", "correct": false}, {"label": "B", "text": "Hoffer Q", "correct": false}, {"label": "C", "text": "Haigis", "correct": true}, {"label": "D", "text": "Holladay I", "correct": false}], "correct_answer": "C. Haigis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>SRK (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hoffer Q (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Holladay I (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>P= A-2.5L-0.9K<br/>\n\t\t\t\t(L= <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length)<br/>\n\t\t\t\t(K= constant)</li>\n<li>Normal <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length (24 mm)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Short <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length (&lt;22mm)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length ( &gt;24.5 mm)</li>\n</ul>\n<br/>\n\t\t\t </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2icNIgS64hNOUdAGrodM1744901506.mp3", "video": ""}, {"text": "In which scenario is a posterior capsule tear more commonly observed during cataract surgery?", "options": [{"label": "A", "text": "During phacoemulsification with high energy settings", "correct": false}, {"label": "B", "text": "During cortical clean-up with a manual irrigation-aspiration technique", "correct": true}, {"label": "C", "text": "During hydrodelineation", "correct": false}, {"label": "D", "text": "During anterior chamber maintenance with a viscoelastic substance", "correct": false}], "correct_answer": "B. During cortical clean-up with a manual irrigation-aspiration technique", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/cA5DqEZV3hnkHZJESbjm1744902265.mp3", "video": ""}, {"text": "A 70-year-old woman with a history of hypertension and high myopia undergoes cataract surgery. During the procedure, she suddenly experiences severe ocular pain and a rapid rise in intraocular pressure. Fundoscopic examination reveals a dark red elevation in the choroidal region. Which of the following is the most appropriate immediate management step?", "options": [{"label": "A", "text": "Intraoperative posterior sclerostomy", "correct": false}, {"label": "B", "text": "Increase the infusion pressure in the anterior chamber", "correct": false}, {"label": "C", "text": "Perform immediate vitrectomy to drain the hemorrhage", "correct": false}, {"label": "D", "text": "Close the surgical wound and monitor intraocular pressure", "correct": true}], "correct_answer": "D. Close the surgical wound and monitor intraocular pressure", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/OIxuf1k8DVzABmwRrd7T1743623684.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Immediate</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Subsequate</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Closure of the <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> with a <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> to retain <span class=\"customMeta\" data-dictid=\"a459f313d9169277719789fdfb7ada\">residual</span> <span class=\"customMeta\" data-dictid=\"c771cf5a291692777202cf053d7550\">viscoelastic</span> in the eye.</li>\n<li>Diagnosis should be confirmed at the slit-lamp as soon as possible.</li>\n<li>Acetazolamide to lower <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure.</li>\n<li>Intensive <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> and <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> steroids to reduce inflammation, with standard <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"ff6b4f4d491692777181a02bad075e\">antibiotic</span> treatment and IOP management.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Drainage, if subsequent <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> fails to resolve (after 7-14 days, by which <span class=\"customMeta\" data-dictid=\"8170dc8ad81692777191ec56a3f27c\">liquefaction</span> of <span class=\"customMeta\" data-dictid=\"40d68b98721692777183c42090e023\">blood clot</span> has taken place).</li>\n<li>Pars <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> <span class=\"customMeta\" data-dictid=\"e6aa17c07816927772024116d41015\">vitrectomy</span> may be considered when the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> appears adherent or detached.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4ZUrUbyYSQUBtNr75hz01744955297.mp3", "video": ""}, {"text": "Which of the following is not a condition associated with a shallow anterior chamber?", "options": [{"label": "A", "text": "Wound leak with hypotony", "correct": false}, {"label": "B", "text": "Ciliochoroidal detachment", "correct": false}, {"label": "C", "text": "Vitreous bulge", "correct": false}, {"label": "D", "text": "Iridodialysis", "correct": true}], "correct_answer": "D. Iridodialysis", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">Postoperative</span> complications </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Late <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">Postoperative</span> complications </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>UGH syndrome (uveitis-glaucoma-hyphema) due to ACIOL</li>\n<li>Iris prolapse</li>\n<li>Striate keratopathy</li>\n<li>Flat <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</li>\n<li>Toxic <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> segment syndrome: <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> infection within 24 hours.Inflammatory reaction due to <span class=\"customMeta\" data-dictid=\"9996ef505516927771937fe4ef1222\">non</span> <span class=\"customMeta\" data-dictid=\"aa279cf1f016927771903f195bb1b9\">infectious</span> substances like <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> solutions used in <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber in surgery</li>\n<li>Bacterial endophthalmitis: <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> infection within 4-7 days by Staph epidermidis( CONS)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</li>\n<li>Late post op <span class=\"customMeta\" data-dictid=\"d7e86ebfd9169277718767de545052\">endophthalmitis</span> after 6 weeks by <span class=\"customMeta\" data-dictid=\"77ba04808316927771963f119df5a5\">propionibacterium</span> acnes</li>\n<li>Irwin Gass syndrome</li>\n<li>Retinal detachment</li>\n<li>Epithelial ingrowth</li>\n<li>Fibrous downgrowth</li>\n<li>After cataract/Secondary cataract</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lex3Ld5WRlL0Jtnyj9KY1744955693.mp3", "video": ""}, {"text": "A 67-year-old man had undergone cataract surgery. He presents with endophthalmitis after 3 days. His infection is severe with vision reduced to hand movements close to the face. What is the most appropriate management?", "options": [{"label": "A", "text": "Intravitreal antibiotics", "correct": false}, {"label": "B", "text": "Systemic antibiotics", "correct": false}, {"label": "C", "text": "Steroid therapy", "correct": false}, {"label": "D", "text": "Vitrectomy", "correct": true}], "correct_answer": "D. Vitrectomy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/rcIwBdzIMoEcl5LVV8Ez1743623813.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inflammation of inner structures of the eye (uveal tissue and retina) with exudates in the vitreous, anterior, and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> chambers. It spares sclera.</li>\n<li><strong>Acute bacterial <span class=\"customMeta\" data-dictid=\"d7e86ebfd9169277718767de545052\">endophthalmitis</span> happens 1-7 days post <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> surgery</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>M/C <span class=\"customMeta\" data-dictid=\"f616aee08b169277718361438e1a91\">causative</span> organism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Staphylococcus epidermidis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Presentation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> pain</li>\n<li>Redness</li>\n<li>Lacrimation</li>\n<li>Photophobia</li>\n<li>Loss of vision</li>\n<li>Red and swollen lids</li>\n<li>Conjunctival chemosis</li>\n<li>Circumcorneal congestion</li>\n<li>Cloudy cornea</li>\n<li>Ring infiltration</li>\n<li>Yellow necrotic wound edges</li>\n<li>Hypopyon</li>\n<li>Oedematous and muddy iris</li>\n<li>Yellow <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> due to <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> exudation</li>\n<li>Vitreous <span class=\"customMeta\" data-dictid=\"1f6bbb967d16927771871c1894ea2e\">exudation</span> which causes amaurotic cat's-eye reflex</li>\n<li>Raised <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure initially</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Intravitreal antibiotics:\n\t\t\t\t<ul>\n<li>First choice: Vancomycin 1 mg + <span class=\"customMeta\" data-dictid=\"35f8bd21b81692777184e67c25725d\">Ceftazidime</span> 2.25 mg</li>\n<li>Second choice: Vancomycin 1 mg + <span class=\"customMeta\" data-dictid=\"29b51ba65b1692777181574e73b9ae\">Amikacin</span> 0.4 mg</li>\n</ul>\n</li>\n<li>Topical antibiotics</li>\n<li>Systemic antibiotics</li>\n<li>Steroid Therapy</li>\n<li>Supportive Therapy</li>\n<li><strong>Vitrectomy - if no improvement in 48-72 hours or if severe infection with vision <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> to hand movements close to the face</strong></li>\n<li>If blind - no perception of light - Evisceration.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vPjzrL0MiNppHnNFxUXU1744956079.mp3", "video": ""}, {"text": "A 65-year-old man has undergone cataract surgery. He has now returned after 6 weeks with endophthalmitis. What is the most likely organism that caused the infection?", "options": [{"label": "A", "text": "Staphylococcus aureus", "correct": false}, {"label": "B", "text": "Streptococcus pyogenes", "correct": false}, {"label": "C", "text": "Propionibacterium acnes", "correct": true}, {"label": "D", "text": "Staphylococcus epidermidis", "correct": false}], "correct_answer": "C. Propionibacterium acnes", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:620px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>After 6-weeks of <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> surgery</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Course</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Slow, with a panuveitis-like picture</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Granulomatous <span class=\"customMeta\" data-dictid=\"9f27a2a3421692777190e4154fc8fc\">keratic</span> precipitates</li>\n<li>Inflammatory deposits over <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> lens (IOL)</li>\n<li>White capsular plaque</li>\n<li>Anterior chamber reaction</li>\n<li>Vitritis</li>\n<li>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> (CME)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Response to Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>May respond to <span class=\"customMeta\" data-dictid=\"e25c12b0d21692777195e9dbff2422\">periocular</span> or <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> steroids but usually recurs</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common <span class=\"customMeta\" data-dictid=\"f616aee08b169277718361438e1a91\">Causative</span> Organisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bacterial: <strong>Propionibacterium acnes (most common)</strong>, Coagulase-negative Staphylococcus</li>\n<li>Fungal: Aspergillus, Candida, and others</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/I6UUQelNRQvxHAn6SjWB1744956251.mp3", "video": ""}, {"text": "Soemmering's Ring and Elschnig's Pearls are examples of which of the following?", "options": [{"label": "A", "text": "After cataracts", "correct": true}, {"label": "B", "text": "Senile cataracts", "correct": false}, {"label": "C", "text": "Congenital cataracts", "correct": false}, {"label": "D", "text": "Toxic cataracts", "correct": false}], "correct_answer": "A. After cataracts", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/aIzkt5kimQwNCtwnJgT11743623920.png", "https://image.prepladder.com/notes/PVciTHJjrSjoT98XLRSz1743623956.png", "https://image.prepladder.com/notes/O8cIjb7hrhsE6SOIz1421743624109.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>M/C <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> following <span class=\"customMeta\" data-dictid=\"ab0f3917ce1692777187309ec78709\">extracapsular</span> lens extraction.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Posterior <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">Capsule</span> <span class=\"customMeta\" data-dictid=\"990cbfd3111692777194c6967ee125\">Opacification</span> (PCO)</strong>: Common <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of after cataract.</li>\n<li>Dense Membranous After Cataract: Thick <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> formation.</li>\n</ul>\n<img alt=\"OP049\" data-author=\"\" data-hash=\"6715\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/aIzkt5kimQwNCtwnJgT11743623920.png\"/>\n<ul>\n<li><strong>Soemmering's Ring:</strong> Thick ring behind the iris, enclosed between <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> layers.</li>\n</ul>\n\t\t\t <img alt=\"OP050\" data-author=\"\" data-hash=\"6718\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/PVciTHJjrSjoT98XLRSz1743623956.png\"/>\n<ul>\n<li><strong>Elschnig's Pearls:</strong> Clustered, <span class=\"customMeta\" data-dictid=\"869a7f073716927772017c4d29804a\">vacuolated</span> <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> epithelial cells along the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> capsule.</li>\n</ul>\n<p><img alt=\"OP051\" data-author=\"\" data-hash=\"6725\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/O8cIjb7hrhsE6SOIz1421743624109.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>ND YAG laser <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> capsulotomy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gVLWuyJlgPnl6ZUswzCY1744956384.mp3", "video": ""}, {"text": "A key advantage of peribulbar anesthesia over retrobulbar anesthesia is:", "options": [{"label": "A", "text": "Faster onset of anesthesia", "correct": false}, {"label": "B", "text": "Less risk of globe perforation", "correct": true}, {"label": "C", "text": "Better akinesia of the eye", "correct": false}, {"label": "D", "text": "Reduced risk of systemic toxicity", "correct": false}], "correct_answer": "B. Less risk of globe perforation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retrobulbar block</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peribulbar block</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Injection Site</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inside the muscle <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> (intraconal)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Outside the muscle <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> (extraconal)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Onset of Anesthesia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Faster onset</strong><strong> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slower onset</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Akinesia (Eye Movement)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Better <span class=\"customMeta\" data-dictid=\"d982f6f0e51692777180c5b7c7fe74\">akinesia</span> due to direct nerve <span class=\"customMeta\" data-dictid=\"70d039f1401692777183bb2f23a21a\">blockade</span> </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable akinesia,may require multiple injections</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk of Globe <span class=\"customMeta\" data-dictid=\"23b5d65f051692777195987380382d\">Perforation</span> and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> nerve injury</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Higher risk due to proximity to the globe and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lower risk</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hemorrhage Risk</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Higher risk of <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> hemorrhage</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lower risk of severe hemorrhage</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1fdCkpg1MObq4hRIsYvB1744901001.mp3", "video": ""}, {"text": "Which of the following statements is true regarding Cystoid Macular Edema?", "options": [{"label": "A", "text": "Collection of fluid in Henle’s layer", "correct": false}, {"label": "B", "text": "Honeycomb appearance in fundoscopy", "correct": false}, {"label": "C", "text": "Antiprostaglandin is both treatment and prevention", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/jfMRi9wQocReia0p8oLe1743624863.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:632px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Collection of fluid in <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> <span class=\"customMeta\" data-dictid=\"4ec0f224ff1692777191e7f5f8e58b\">loculi</span> in the <strong>Henle's layer of the macula</strong></li>\n<li>Defect in OPL layer of retina( inner <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> blood barrier break defect)</li>\n<li>Frequent <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> of <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> surgery</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fundoscopy </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Honeycomb appearance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fluorescein Angiography</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flower <span class=\"customMeta\" data-dictid=\"4808e775cd1692777194747dcab171\">petal</span> pattern</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prevention</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preoperative and <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> use of <strong>anti <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">prostaglandin</span> <span class=\"customMeta\" data-dictid=\"fe2c08a01b1692777187011e915049\">eye drops</span> </strong>(indomethacin, flurbiprofen, or ketorolac)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Anterior vitrectomy</li>\n<li>Steroids</li>\n<li><strong>Antiprostaglandins</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/aF7WYLxcI7fFuu2b5t7l1744957217.mp3", "video": ""}, {"text": "What is the common inheritance pattern of hereditary cataracts?", "options": [{"label": "A", "text": "Autosomal dominant", "correct": true}, {"label": "B", "text": "Autosomal recessive", "correct": false}, {"label": "C", "text": "X linked recessive", "correct": false}, {"label": "D", "text": "X linked dominant", "correct": false}], "correct_answer": "A. Autosomal dominant", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Idiopathic </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sporadic cases with unknown etiology.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hereditary </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Inherited without <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">Systemic</span> Disorders: </strong>\n<ul>\n<li>Usually<strong> autosomal dominant. </strong></li>\n<li>Genes:\n\t\t\t\t\t<ul>\n<li>Cry-G (crystallins).</li>\n<li>Connexins.</li>\n<li>MIP (Major <span class=\"customMeta\" data-dictid=\"a6795c876e169277719057a1099465\">intrinsic</span> protein).</li>\n</ul>\n</li>\n</ul>\n</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Inherited with <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">Systemic</span> Disorders:\n\t\t\t\t<ul>\n<li>Chromosomal disorders (e.g., <span class=\"customMeta\" data-dictid=\"5e54fdc4d3169277720003f231621d\">trisomy</span> 21)</li>\n<li>Skeletal disorders (e.g., Stickler syndrome)</li>\n<li>CNS disorders (e.g., cerebro-oculo-facial syndrome)</li>\n<li>Renal system disorders (e.g., Lowe's syndrome)</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Maternal Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"cbd2d1fd521692777191d00c1a4ede\">Malnutrition</span> during Pregnancy: Associated with nonfamilial zonular cataract.</p>\n<p>2. Infections: <span class=\"customMeta\" data-dictid=\"b8aa1ffb8916927771976438d71d1b\">Rubella</span> (50% of cases), toxoplasmosis, <span class=\"customMeta\" data-dictid=\"63158aab081692777185fc6d827ae1\">cytomegalic</span> <span class=\"customMeta\" data-dictid=\"c3b8b9a17416927771906b1bebb13c\">inclusion</span> disease.</p>\n<p>3. Drug Ingestion: Certain drugs (e.g., thalidomide, corticosteroids) during pregnancy.</p>\n<p>4. Radiation Exposure: <span class=\"customMeta\" data-dictid=\"a191a950d7169277719148e72a75e2\">Maternal</span> exposure to radiation during pregnancy.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Foetal or <span class=\"customMeta\" data-dictid=\"4c815174781692777190e1b4a5d704\">Infantile</span> Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Deficient <span class=\"customMeta\" data-dictid=\"db3aca8a9a16927771948a3ff7512d\">Oxygenation</span> (Anoxia): Due to <span class=\"customMeta\" data-dictid=\"797686400a16927771956b27d401ff\">placental</span> hemorrhage.</p>\n<p>2. Birth Trauma</p>\n<p>3. <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">Metabolic</span> Disorders: Galactosemia, <span class=\"customMeta\" data-dictid=\"0657553117169277718887935b6a43\">galactokinase</span> deficiency, <span class=\"customMeta\" data-dictid=\"77493a5b781692777193df12530299\">neonatal</span> hypoglycemia.</p>\n<p>4. Associated with <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> Anomalies: Down's syndrome, Lowe's syndrome, <span class=\"customMeta\" data-dictid=\"8457970cd216927771938b85b340cf\">myotonia</span> dystrophica, <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> ichthyosis.</p>\n<p>5. <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">Ocular</span> Diseases: <span class=\"customMeta\" data-dictid=\"4bbc5b763e1692777195e887c95450\">Persistent hyperplastic primary vitreous</span> (PHPV), aniridia, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber <span class=\"customMeta\" data-dictid=\"db5610b3121692777184e0965a9fa4\">cleavage</span> syndrome, <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> of prematurity, <span class=\"customMeta\" data-dictid=\"4394a6a42116927771914e2480e2af\">lenticonus</span> posterior, microphthalmos.</p>\n<p>6. <span class=\"customMeta\" data-dictid=\"cbd2d1fd521692777191d00c1a4ede\">Malnutrition</span> in Early Infancy</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MWX1B9vvZZx0mkVVPbjq1744958830.mp3", "video": ""}, {"text": "Doctor noticed leukocoria in a 3-month-old baby during a routine examination and the eye appeared as shown below. Choose the least appropriate statement regarding the most likely diagnosis.", "options": [{"label": "A", "text": "Most common type of congenital cataract", "correct": true}, {"label": "B", "text": "Commonly inherited as autosomal dominant trait", "correct": false}, {"label": "C", "text": "Usually zone of fetal nucleus is involved", "correct": false}, {"label": "D", "text": "Associated with vitamin-D deficiency", "correct": false}], "correct_answer": "A. Most common type of congenital cataract", "question_images": ["https://image.prepladder.com/notes/LeDHuOctgIsFyqnE0Cwv1743625041.png"], "explanation_images": ["https://image.prepladder.com/notes/o2NqFnCFBWx8GaChHiAT1743625112.png", "https://image.prepladder.com/notes/thdlP2zjYhNzriyfrt941743625155.png", "https://image.prepladder.com/notes/LeDHuOctgIsFyqnE0Cwv1743625041.png", "https://image.prepladder.com/notes/Z2vfSVPUxtGuENHmQxUl1743625195.png", "https://image.prepladder.com/notes/ukjkbfRtP1Ia4YJ8GDJu1743625350.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Polar cataracts </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior <span class=\"customMeta\" data-dictid=\"a274393046169277719601ea5a6864\">polar</span> cataract:</strong></p>\n<ul>\n<li>Usually associated with persistent pupillary membrane.</li>\n<li>Non-axial, stationary, asymptomatic.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior <span class=\"customMeta\" data-dictid=\"a274393046169277719601ea5a6864\">polar</span> cataract:</strong></p>\n<img alt=\"OP057\" data-author=\"\" data-hash=\"6731\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/o2NqFnCFBWx8GaChHiAT1743625112.png\"/>\n<p>Onion ring / whorled appearance</p>\n<p>Associated with :</p>\n<ul>\n<li>mittendorf dots</li>\n<li>PHPV</li>\n<li>PITX 3 Mutation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Congenital nuclear cataracts</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cataracta <span class=\"customMeta\" data-dictid=\"9d06bb6ad916927771841ac5cb7458\">centralis</span> pulverulenta:</strong></p>\n<ul>\n<li>Powdery <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> at the center of lens.</li>\n<li>Usually does not cause vision problems.</li>\n</ul>\n<img alt=\"OP058\" data-author=\"\" data-hash=\"6732\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/thdlP2zjYhNzriyfrt941743625155.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lamellar cataract: (zonular cataract)</strong></p>\n<ul>\n<li>Most common <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> affecting vision</li>\n<li>Infantile <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> &lt;1 yr child</li>\n<li>Associated with genetic and environmental causes like vitamin-D <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> <strong>(Option D)</strong><strong>, </strong>congenital <span class=\"customMeta\" data-dictid=\"b8aa1ffb8916927771976438d71d1b\">rubella</span> syndrome ( but m/c in this is pearly white cataract)</li>\n<li>Inherited as an autosomal dominant trait. <strong>(Option B)</strong></li>\n<li>Zone of the fetal nucleus is involved. <strong>(Option C)</strong></li>\n<li>Radial opacities (Riders) are seen.</li>\n</ul>\n<p><img alt=\"OP056\" data-author=\"\" data-hash=\"6730\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/LeDHuOctgIsFyqnE0Cwv1743625041.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sutural cataract:</strong></p>\n<ul>\n<li>Punctate opacities scattered around Y-sutures</li>\n<li>Patterns: Floriform, Coralliform, <span class=\"customMeta\" data-dictid=\"77f797c5e8169277718535480fa7fd\">Dendritic</span> sutural</li>\n</ul>\n<img alt=\"OP059\" data-author=\"\" data-hash=\"6733\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Z2vfSVPUxtGuENHmQxUl1743625195.png\"/></td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Generalized cataracts </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Coronary cataract:</strong></p>\n<ul>\n<li>Adolescent onset cataract</li>\n<li>Numerous club-shaped opacities in the periphery</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blue dot <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (cataracta-punctata-caerulea):</strong></p>\n<ul>\n<li>Most common type of <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> <strong>(Option A) </strong></li>\n<li>Developmental <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (seen &gt; 1 year child)</li>\n<li>Does not cause vision problems</li>\n<li>Associated with Down’s syndrome<img alt=\"OP060\" data-author=\"\" data-hash=\"6734\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ukjkbfRtP1Ia4YJ8GDJu1743625350.png\"/></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Total <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> cataract</strong> (TORCH infections)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/w6RysZlMK5pwiAFQ0gGR1748245360.mp3", "video": ""}, {"text": "An infant with leukocoria presents with recurrent gastrointestinal infections and developmental regression. Bilateral eye examination revealed the following. Choose the most appropriate next step in evaluation.", "options": [{"label": "A", "text": "Serum estimation of glucose, calcium, and phosphorous levels", "correct": false}, {"label": "B", "text": "Estimation of antibody titers for infections", "correct": false}, {"label": "C", "text": "Urine chromatography for amino acids", "correct": false}, {"label": "D", "text": "Urine assay for the presence of reducing substances", "correct": true}], "correct_answer": "D. Urine assay for the presence of reducing substances", "question_images": ["https://image.prepladder.com/notes/bjJ2JOl33jv5khwOCJT91743625642.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inborn error of <span class=\"customMeta\" data-dictid=\"99e53092e01692777188465c49d9b8\">galactose</span> metabolism.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description and types </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Classical Galactosaemia: <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> of <strong>galactose-1-phosphate uridyltransferase</strong> (GPUT).</li>\n<li>Non-classical type: <span class=\"customMeta\" data-dictid=\"0657553117169277718887935b6a43\">Galactokinase</span> deficiency</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristic Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Frequently leads to <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> formation.</li>\n<li>Cataracts often present as oil <span class=\"customMeta\" data-dictid=\"33843a1c3716927771867f807275d2\">droplet</span> central lens opacities.</li>\n<li>Recurrent infections with <span class=\"customMeta\" data-dictid=\"c2ea0d4bf01692777187d486aa6385\">Escherichia</span> coli.</li>\n<li>Mental retardation/developmental delay.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management and prognosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Avoidance of milk and milk-based products.</li>\n<li>Cataract changes are reversible.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>Blood analysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Levels of blood glucose, <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> and <span class=\"customMeta\" data-dictid=\"bfea0730ac16927771959eb551740f\">phosphorus</span> to rule out <span class=\"customMeta\" data-dictid=\"c52b35ebb01692777189131c97fbba\">Hyperglycemia</span> and Hypocalcemia. <strong>(Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Red blood cell <span class=\"customMeta\" data-dictid=\"2288cbf3741692777200318d2f5b39\">transferase</span> and <span class=\"customMeta\" data-dictid=\"0657553117169277718887935b6a43\">galactokinase</span> levels - for Galactosemia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Antibody titres for infections such as toxoplasmosis, rubella, <span class=\"customMeta\" data-dictid=\"ee831318721692777185479e65655e\">cytomegalovirus</span> and <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> simplex virus (TORCH) and <span class=\"customMeta\" data-dictid=\"39867f177b16927771888cf43850d5\">hepatitis</span> B virus. <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Urine analysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Urine <span class=\"customMeta\" data-dictid=\"fc026ff6d81692777182835f6de6df\">assay</span> for reducing substances</strong> - for Galactosaemia. <strong>(Option D)</strong></li>\n<li>Screening for <span class=\"customMeta\" data-dictid=\"543f207eb51692777181723491a358\">amino</span> acids in the <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> - if <strong>Lowe syndrome</strong> is suspected. <strong>(Option C)</strong></li>\n<li>Blood in <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> - Alport syndrome</li>\n<li>Estimation of <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> in <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> - Wilson disease</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kSfxnOyNTDWr0rAitbez1744959857.mp3", "video": ""}, {"text": "A 1-month-old infant is diagnosed with a dense unilateral cataract. Which of the following is the most appropriate management strategy?", "options": [{"label": "A", "text": "Delay surgery until the child is 1–2 years old to reduce surgical risks", "correct": false}, {"label": "B", "text": "Perform immediate cataract surgery", "correct": true}, {"label": "C", "text": "Prescribe glasses and monitor the cataract progression", "correct": false}, {"label": "D", "text": "Wait until the child develops strabismus before considering surgery", "correct": false}], "correct_answer": "B. Perform immediate cataract surgery", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Timing of Surgery</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Unilateral cataracts: as early as possible. </strong><strong>(Option B)</strong></li>\n<li><strong>After 1 month of age for <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">bilateral</span> cataracts.</strong> <strong>(Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Surgical Technique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Small, ideally 1–1.5 mm <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> incisions.</li>\n<li><strong>Posterior capsulorhexis with <span class=\"customMeta\" data-dictid=\"4bc4237fe3169277719497604c0f00\">pars</span> <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> vitrectomy</strong> is done additionally to reduce the risk of After-cataract.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optical Rehabilitation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contact lenses/glasses: for children below 2 years age</li>\n<li><strong>IOLs: Generally preferred in children above 2 years age</strong></li>\n<li>Foldable <span class=\"customMeta\" data-dictid=\"e3be2eb847169277718953f0dae57d\">hydrophobic</span> <span class=\"customMeta\" data-dictid=\"8767f188261692777180a2438ce386\">acrylic</span> IOLs are preferred over PMMA.</li>\n<li><strong>Always placed with undercorrection.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tdg5CL3KztNxG5pnpYur1744960582.mp3", "video": ""}, {"text": "A newborn presented with the following findings. There is a positive maternal history for fever during the first trimester of pregnancy. Which among the following is least likely to be seen in this newborn?", "options": [{"label": "A", "text": "Patent ductus arteriosus", "correct": false}, {"label": "B", "text": "Limb hypoplasia", "correct": true}, {"label": "C", "text": "Microphthalmia", "correct": false}, {"label": "D", "text": "Sensorineural hearing loss", "correct": false}], "correct_answer": "B. Limb hypoplasia", "question_images": ["https://image.prepladder.com/notes/hZmX1778EHFQOJHIoOHu1743625506.png", "https://image.prepladder.com/notes/TGJXw0VnLgrf1PhlfypY1743625762.png"], "explanation_images": ["https://image.prepladder.com/notes/TGJXw0VnLgrf1PhlfypY1743625762.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Maternal <span class=\"customMeta\" data-dictid=\"b8aa1ffb8916927771976438d71d1b\">rubella</span> infection <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> in 1st trimester</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>a. <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">Ocular</span> Defects:</strong></p>\n<ul>\n<li>Congenital <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (2nd most common manifestation)</li>\n<li><strong>Salt and pepper <span class=\"customMeta\" data-dictid=\"7b543eabc216927771846642ae5566\">chorioretinopathy</span> </strong>(<strong>most common </strong>feature)</li>\n<li>Microphthalmia <strong>(Option C)</strong></li>\n<li>Cloudy cornea</li>\n<li>Poorly dilating pupil</li>\n</ul>\n<p><strong>b. Ear Defects: </strong>Sensorineural <span class=\"customMeta\" data-dictid=\"f3f80e5bee1692777188f6eb1c4005\">hearing loss</span> <strong>(Option D)</strong></p>\n<p><strong>c. <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">Cardiovascular</span> Defects:</strong></p>\n<ul>\n<li><strong>Patent <span class=\"customMeta\" data-dictid=\"7a6864e97b169277718602072817ee\">ductus</span> arteriosus</strong> <strong>(Option A)</strong></li>\n<li>Pulmonary stenosis</li>\n<li>Ventricular septal defects</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>RT-PCR/IgM <span class=\"customMeta\" data-dictid=\"9d7a12cab116927771811a0079086d\">antibody</span> titres</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prevention</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Administration of <span class=\"customMeta\" data-dictid=\"b8aa1ffb8916927771976438d71d1b\">rubella</span> vaccine at least three months before pregnancy.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP062\" data-author=\"\" data-hash=\"6737\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/TGJXw0VnLgrf1PhlfypY1743625762.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<ul>\n<li>Congenital <span class=\"customMeta\" data-dictid=\"b8aa1ffb8916927771976438d71d1b\">Rubella</span> syndrome</li>\n<li>Congenital Syphilis</li>\n<li>Myotonic dystrophy</li>\n<li>Retinitis pigmentosa sine pigmento</li>\n<li>Leber’s amaurosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VkwqSd3wQUzcY7yPuOQG1746167637.mp3", "video": ""}, {"text": "A school-going child is diagnosed with a connective tissue disorder characterized by abnormalities of the eye, short stature, brachydactyly, joint stiffness, and cardiovascular defects. Which among the following is incorrect regarding the likely diagnosis?", "options": [{"label": "A", "text": "Follows autosomal recessive mode of inheritance", "correct": false}, {"label": "B", "text": "Associated with supero-temporal lens dislocation", "correct": true}, {"label": "C", "text": "Molecular genetic analysis is confirmatory", "correct": false}, {"label": "D", "text": "Usual age of presentation is 5-10 years", "correct": false}], "correct_answer": "B. Associated with supero-temporal lens dislocation", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/MuEH0BpWDt2fEri5EZTL1743625929.png", "https://image.prepladder.com/notes/BOrmI67uDgfzJ36VM4BF1743625950.png", "https://image.prepladder.com/notes/KS4hJOAJVPH6rA8b3Vp01743626010.png", "https://image.prepladder.com/notes/IP5uiKgoLmZ8pkMBKlZa1743626033.png", "https://image.prepladder.com/notes/h1DHXW8m1TTsMQXfX4I41743626091.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Marfan's Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Autosomal dominant</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>B/L <strong>Supero-temporal dislocation</strong>, Megalocornea</p>\n<p><img alt=\"OP063\" data-author=\"\" data-hash=\"6738\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/MuEH0BpWDt2fEri5EZTL1743625929.png\"/><img alt=\"OP064\" data-author=\"\" data-hash=\"6739\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/BOrmI67uDgfzJ36VM4BF1743625950.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Arachnodactyly, long limbs, <strong>hypermobile joints</strong>, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> defects</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Homocystinuria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Autosomal recessive</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infero-nasal dislocation</strong></p>\n<p>A/w zonular breaks and hence loss of accommodation</p>\n<p><img alt=\"OP065\" data-author=\"\" data-hash=\"6740\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/KS4hJOAJVPH6rA8b3Vp01743626010.png\"/><img alt=\"OP066\" data-author=\"\" data-hash=\"6741\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/IP5uiKgoLmZ8pkMBKlZa1743626033.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detection of <span class=\"customMeta\" data-dictid=\"00472d632e1692777189a71b99d4a9\">homocysteine</span> in <span class=\"customMeta\" data-dictid=\"0096f2a7631692777201eb9f21d5a7\">urine</span> using the sodium <span class=\"customMeta\" data-dictid=\"4e995cdee9169277719375efd43d38\">nitroprusside</span> test.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Weill-Marchesani Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Autosomal <span class=\"customMeta\" data-dictid=\"d54db2110416927771971e7c011a9f\">recessive</span> </strong><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Microspherophakia, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">Inferior</span> or forward <span class=\"customMeta\" data-dictid=\"e53b153fb316927771996481a3e88f\">subluxation</span> of the lens</strong></p>\n<img alt=\"OP067\" data-author=\"\" data-hash=\"6742\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/h1DHXW8m1TTsMQXfX4I41743626091.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Short stature, brachydactyly, <strong>joint stiffness</strong>, <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> defects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ehlers-Danlos Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lens subluxation, <strong>blue sclera</strong>, Hyperextensible joints</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stickler Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Liquified vitreous, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, Pre-senile cataract</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oro-facial abnormalities, arthropathy</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Sulphite <span class=\"customMeta\" data-dictid=\"4a14dfa14e1692777194882f818d87\">Oxidase</span> Deficiency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Autosomal recessive</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ectopia lentis, Progressive <span class=\"customMeta\" data-dictid=\"9e2d8a3f5a16927771932c2348ec52\">muscular</span> rigidity</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Death usually by 5 years of age</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LNkAZ0LreU4GhUhR88DH1746168111.mp3", "video": ""}, {"text": "Which of the following is the thinnest part of the lens capsule?", "options": [{"label": "A", "text": "Anterior pole", "correct": false}, {"label": "B", "text": "Posterior pole", "correct": true}, {"label": "C", "text": "Equator", "correct": false}, {"label": "D", "text": "Pre-equatorial region", "correct": false}], "correct_answer": "B. Posterior pole", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/VZgugOf0cURBMttTcaCd1743619431.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kiixRo3v1snbD3gD0AAL1744274593.mp3", "video": ""}, {"text": "What are the steps involved in FLACS?", "options": [{"label": "A", "text": "Capsulorrhexis → Corneal Incision → Lens Fragmentation → IOL implantation", "correct": false}, {"label": "B", "text": "Corneal Incision → Capsulorrhexis → Lens Fragmentation → IOL implantation", "correct": false}, {"label": "C", "text": "Capsulorrhexis → Lens Fragmentation → Corneal Incision → IOL implantation", "correct": true}, {"label": "D", "text": "Corneal Incision → Lens Fragmentation → Capsulorrhexis → IOL implantation", "correct": false}], "correct_answer": "C. Capsulorrhexis → Lens Fragmentation → Corneal Incision → IOL implantation", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ZbSqfydtuqTQvsoALNL21743622200.png", "https://image.prepladder.com/notes/k5fpsTYf5DFv9LHBN7V91743622139.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qX2KUsC5SBPxfBRB3Y6v1744900775.mp3", "video": ""}, {"text": "A 70-year-old woman presents for cataract surgery in her right eye. She has moderate cataract density with some nuclear sclerosis and a clear cornea. She expresses a strong desire for a procedure that minimizes recovery time and provides optimal visual outcomes. Which of the following statements accurately reflects the advantage of Phacoemulsification Over Manual SICS?", "options": [{"label": "A", "text": "Manual SICS typically requires a smaller incision compared to Phacoemulsification.", "correct": false}, {"label": "B", "text": "Manual SICS allows for faster visual recovery compared to Phacoemulsification.", "correct": false}, {"label": "C", "text": "Manual SICS is less suitable for very hard cataracts compared to Phacoemulsification.", "correct": false}, {"label": "D", "text": "Manual SICS usually results in a higher level of postoperative astigmatism compared to Phacoemulsification.", "correct": true}], "correct_answer": "D. Manual SICS usually results in a higher level of postoperative astigmatism compared to Phacoemulsification.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/xYborB50KtAKOZDsc2ca1743622434.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Manual SICS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phacoemulsification</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extracapsular <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">Extraction</span> (ECCE)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extracapsular <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">Extraction</span> (ECCE)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Incision Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Self-sealing, valvular, <span class=\"customMeta\" data-dictid=\"c84d4595ee16927771982fb138546d\">sclerocorneal</span> tunnel incision</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Self-sealing, valvular, <span class=\"customMeta\" data-dictid=\"c84d4595ee16927771982fb138546d\">sclerocorneal</span> tunnel <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> or <strong>clear corneal incision</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anesthesia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Local <span class=\"customMeta\" data-dictid=\"e24b7bd55d16927771818aaa6ad0ed\">anesthesia</span> (can be performed under)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Local <span class=\"customMeta\" data-dictid=\"e24b7bd55d16927771818aaa6ad0ed\">anesthesia</span> (can also be performed under <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> anesthesia)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nucleus Removal Method</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Manually extracted through the <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> after being maneuvered out of the capsular bag</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fragmented using an <span class=\"customMeta\" data-dictid=\"bcac4e876316927772019cfe289240\">ultrasonic</span> <span class=\"customMeta\" data-dictid=\"175eb86b5f16927771964d5ced6bf3\">probe</span> and then aspirated</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Suitability</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Suitable for all <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> densities, including very hard cataracts</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Typically requires a smaller incision, less suitable for very hard cataracts</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Recovery</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slower visual recovery, delayed return to <span class=\"customMeta\" data-dictid=\"208cf74d74169277719486afd05eb3\">optimal</span> vision</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Faster visual rehabilitation due to smaller <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> and <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> tissue manipulation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Astigmatism</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Higher levels of surgically <span class=\"customMeta\" data-dictid=\"f3063c1d8b169277719018bf869980\">induced</span> astigmatism, larger incision</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> due to smaller <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> size</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complication Risks</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lower risk of nuclear drop</li>\n<li>Higher risk of <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> pain and inflammation, <span class=\"customMeta\" data-dictid=\"e53fabffaa16927771897154b79eed\">hyphema</span> and conjunctival congestion</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lower risk of <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> pain, conjunctival congestion, <span class=\"customMeta\" data-dictid=\"e53fabffaa16927771897154b79eed\">hyphema</span> and inflammation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Overall Accessibility</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More accessible due to cost-effectiveness and versatility</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preferred in settings with better resources and where faster recovery is prioritized</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Ij5A6fISMPFRsURA3XMS1744900504.mp3", "video": ""}, {"text": "Which of the following steps is used to maintain the depth of the anterior chamber and protect the corneal endothelium during Conventional ECCE?", "options": [{"label": "A", "text": "Anterior capsulotomy", "correct": false}, {"label": "B", "text": "Viscoelastic injection", "correct": true}, {"label": "C", "text": "Corneoscleral section completion", "correct": false}, {"label": "D", "text": "Hydrodissection", "correct": false}], "correct_answer": "B. Viscoelastic injection", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/skFusfpxDCAyjon4xpHr1743621909.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:574px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Surgery </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Site of <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Size of <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conventional ECCE</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>At the limbus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>8-10mm</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>SICS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sclera</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-7mm</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phacoemulsification </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cornea</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2.2-3.2mm</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Microincision (MICS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cornea</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt;1.8mm</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bwPTuo0729gxQ2z97xru1744899696.mp3", "video": ""}, {"text": "A 38-year-old patient with diabetes presents with rapidly worsening vision. Upon examination, the ophthalmologist notes the presence of bilateral, snowflake-like white opacities in the cortex of the lens. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Senile cataract", "correct": false}, {"label": "B", "text": "Christmas tree cataract", "correct": false}, {"label": "C", "text": "Diabetic cataract", "correct": true}, {"label": "D", "text": "Posterior subcapsular cataract", "correct": false}], "correct_answer": "C. Diabetic cataract", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/tGvRR77PCrEw6XF3G8Ch1743621625.png", "https://image.prepladder.com/notes/Hz1G4LwkAGPFCJJhiWoR1743621682.png", "https://image.prepladder.com/notes/X1Te7vPqttBff5ooQgcH1743621729.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:738px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Shield <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Christmas tree <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Snowflake/snowstorm cataract</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Atopic dermatitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Myotonic dystrophy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diabetes mellitus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP034\" data-author=\"\" data-hash=\"6617\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/tGvRR77PCrEw6XF3G8Ch1743621625.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP035\" data-author=\"\" data-hash=\"6618\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Hz1G4LwkAGPFCJJhiWoR1743621682.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP036\" data-author=\"\" data-hash=\"6619\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/X1Te7vPqttBff5ooQgcH1743621729.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WlDt4dE4PRaTl2YOHxVx1744898944.mp3", "video": ""}, {"text": "A 35-year-old man presents with decreased vision in his right eye following a blunt trauma a few weeks ago. On examination, feathery opacities are noted. What is the most likely type of cataract this patient has developed?", "options": [{"label": "A", "text": "Subepithelial opacities", "correct": false}, {"label": "B", "text": "Diffuse concussion cataract", "correct": false}, {"label": "C", "text": "Rosette cataract", "correct": true}, {"label": "D", "text": "Morgagnian cataract", "correct": false}], "correct_answer": "C. Rosette cataract", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pAlIlYsXUT6nZDRyXmhI1743621507.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/EOgTwFrldkCZJoZ6zKTg1744898740.mp3", "video": ""}, {"text": "Match the type of cataract with the etiology Type of cataract Etiology a. Posterior subcapsular 1. Glassblowers b. Anterior subcapsular-granular 2. Miotics c. Posterior cortical 3. Steroids", "options": [{"label": "A", "text": "a1,b2,c3", "correct": false}, {"label": "B", "text": "a3,b2,c1", "correct": true}, {"label": "C", "text": "a2,b1,c3", "correct": false}, {"label": "D", "text": "a2,b3,c1", "correct": false}], "correct_answer": "B. a3,b2,c1", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/fYqifqbxIfNHQkBlQGSO1743621252.png", "https://image.prepladder.com/notes/FF8m6wAJwEsodZLOOVGr1743621340.png", "https://image.prepladder.com/notes/4PS7proZZs7IoKUbv2kf1743621392.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZKMQSP81BhCKGTSnK1gW1744898544.mp3", "video": ""}, {"text": "A 30-year-old male with retinitis pigmentosa has developed a cataract as a complication. Which of the following is a feature of his cataract? Posterior subcapsular cortical cataract Irregular in outline Variable density Breadcrumb appearance Polychromatic luster Diffuse yellow haze in the adjoining cortex", "options": [{"label": "A", "text": "1,6,3,6", "correct": false}, {"label": "B", "text": "2,4,5,6", "correct": false}, {"label": "C", "text": "1,2,3,4", "correct": false}, {"label": "D", "text": "1,2,3,4,5,6", "correct": true}], "correct_answer": "D. 1,2,3,4,5,6", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/bN0DVygNziOZuD4HwbEF1743621110.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:632px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cataracts which develop as a <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> of some other <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> disease</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes </strong></p>\n<p><strong>(mnemonic: UMAR: </strong></p>\n<p>-Uveitis</p>\n<p>-Myopia</p>\n<p>-Angle-closure glaucoma</p>\n<p>-Retinitis pigmentosa)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inflammations (Anterior <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> is the most common cause of complicated cataracts)</li>\n<li>Degenerative conditions such as <strong>retinitis pigmentosa </strong>and myopic <span class=\"customMeta\" data-dictid=\"3e48c7feaa169277718485430831dd\">chorioretinal</span> degeneration</li>\n<li>Long-standing <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment</li>\n<li>Glaucoma (primary or secondary)</li>\n<li>Intraocular tumors in late stages (retinoblastoma or melanoma)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Starts as a <strong>posterior <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (PSC)</strong></li>\n<li>Irregular outline</li>\n<li>Variable in density</li>\n<li>Slit-lamp:</li>\n</ul>\n<ul>\n<li><strong>\"Breadcrumb” appearance</strong></li>\n<li><strong>'Polychromatic luster”</strong>, i.e. appearance of <span class=\"customMeta\" data-dictid=\"cb1b40b2a7169277719059123de30a\">iridescent</span> colored particles of reds, greens, and blue</li>\n<li>Diffuse yellow haze in the adjoining cortex</li>\n</ul>\n<img alt=\"OP027\" data-author=\"\" data-hash=\"6612\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/bN0DVygNziOZuD4HwbEF1743621110.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jqLTGphvePV5bzc7h3uh1746167091.mp3", "video": ""}, {"text": "Which of the following is not a feature of chalcosis?", "options": [{"label": "A", "text": "Kayser-Fleischer ring", "correct": false}, {"label": "B", "text": "Sunflower cataract", "correct": false}, {"label": "C", "text": "Retinal golden plaques", "correct": false}, {"label": "D", "text": "Oil droplet cataract", "correct": true}], "correct_answer": "D. Oil droplet cataract", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/3oFdnofua1juvHVysvNO1743620927.png", "https://image.prepladder.com/notes/9wjJCEKfdzs7YupJhF0G1743620970.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Specific changes produced by the <span class=\"customMeta\" data-dictid=\"f4a165ac5e169277718113dd5e4a4d\">alloy</span> of <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> in the eye</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Copper ions from the <span class=\"customMeta\" data-dictid=\"f4a165ac5e169277718113dd5e4a4d\">alloy</span> are dissociated electrolytically and deposited under the membranous structures of the eye</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Kayser-Fleischer ring (Option A)</strong>: Golden brown ring due to deposition of <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> under the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> parts of Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> of the cornea</li>\n</ul>\n<img alt=\"OP025\" data-author=\"\" data-hash=\"6610\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/3oFdnofua1juvHVysvNO1743620927.png\"/>\n<ul>\n<li><strong>Sunflower <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (Option B)</strong>: Deposition of <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> under the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> of the lens</li>\n</ul>\n\t\t\t <img alt=\"OP026\" data-author=\"\" data-hash=\"6611\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/9wjJCEKfdzs7YupJhF0G1743620970.png\"/>\n<ul>\n<li><strong>Retina: Golden plaques (Option C)</strong> at the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole that reflect the light with <span class=\"customMeta\" data-dictid=\"84433cae211692777192a484f539bc\">metallic</span> luster</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5HLJEsodjqZdD7kITQKl1744814758.mp3", "video": ""}, {"text": "A 6-month-old girl was diagnosed with galactosemia. An ocular examination has revealed a cataract which developed as a complication. Which of the following statements regarding her cataract is false?", "options": [{"label": "A", "text": "Bilateral", "correct": false}, {"label": "B", "text": "Oil droplet appearance", "correct": false}, {"label": "C", "text": "Periphery of the lens", "correct": true}, {"label": "D", "text": "May be reversed", "correct": false}], "correct_answer": "C. Periphery of the lens", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/EIROHY9ahrg4PoClem4T1743620767.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Galactosemia </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inborn error of <span class=\"customMeta\" data-dictid=\"99e53092e01692777188465c49d9b8\">galactose</span> metabolism</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Enzyme <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Galactose-1-phosphate uridyltransferase (GPUT)</li>\n<li>Galactokinase (GK)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type of <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Bilateral (Option A)</strong></li>\n<li><strong>“Oil droplet” (Option B)</strong></li>\n<li><strong>Central lens (Option C is the false statement) </strong></li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"OP024\" data-author=\"\" data-hash=\"6609\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/EIROHY9ahrg4PoClem4T1743620767.png\"/></p>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>May be reversed (Option D) </strong></li>\n<li>May be prevented if milk and milk products are eliminated at an early stage</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HknOMDDSlfux2hTZFSQT1744813931.mp3", "video": ""}, {"text": "A 45-year-old man is having difficulty in near vision. The ophthalmologist has prescribed him a convex lens and informed him that it is an age-related physiological condition. Which of the following is an age-related change that would have caused his condition?", "options": [{"label": "A", "text": "Decrease in elasticity of lens capsule", "correct": false}, {"label": "B", "text": "Sclerosis of lens substance", "correct": false}, {"label": "C", "text": "Reduced ciliary muscle power", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:631px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Accommodation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The mechanism by which the eyes focus diverging rays from a near object on the retina</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>When looking at a near object from a far object:</p>\n<p>Ciliary muscles contract <strong>→</strong>Zonules relax<strong>→</strong>Lens becomes more <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> anteriorly</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Presbyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Physiological </strong>insufficiency of accommodation, causing <strong>worsening near vision after the age of 40 </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Decrease in <span class=\"customMeta\" data-dictid=\"d6c754309d16927771874142ec8ca4\">elasticity</span> of lens <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> </strong><strong>(Option A)</strong></li>\n<li><strong>Sclerosis of lens substance</strong><strong> (Option B)</strong></li>\n<li><strong>Reduced <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle power </strong><strong>(Option C) </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Convex <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> for near-work</strong></li>\n<li>A guide for powers required at various ages:\n\t\t\t\t<ul>\n<li>45 years: + l to +l.25D</li>\n<li>50 years: +1.5 to +1.75D</li>\n<li>55 years: +2 to +2.25D</li>\n<li>60 years: +2.5 to +30D</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AKy9WAkSdR1TkilgGdKJ1744813665.mp3", "video": ""}, {"text": "An elderly male diabetic patient came with loss of vision in the left eye associated with pain in the left eye. On examination, the left eye appears red, and visual acuity- Perception of light+ and IOP is raised in the same eye. The patient gives history of blurring and diminution of vision for the past 1 year. The slit lamp examination is given below. Choose the correct diagnosis and appropriate pathophysiology for this patient.", "options": [{"label": "A", "text": "Phacomorphic glaucoma - Secondary open-angle glaucoma", "correct": false}, {"label": "B", "text": "Phacomorphic glaucoma - Secondary closed-angle glaucoma", "correct": false}, {"label": "C", "text": "Phacolytic glaucoma - Secondary open-angle glaucoma", "correct": true}, {"label": "D", "text": "Phacolytic glaucoma - Secondary closed-angle glaucoma", "correct": false}], "correct_answer": "C. Phacolytic glaucoma - Secondary open-angle glaucoma", "question_images": ["https://image.prepladder.com/notes/3VWCzwPpyNM9Exy2jEOi1743620543.png"], "explanation_images": ["https://image.prepladder.com/notes/3VWCzwPpyNM9Exy2jEOi1743620543.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Phacomorphic Glaucoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Phacolytic Glaucoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Intumescent <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> blocks the pupil.</li>\n<li>this pushes the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> forward,</li>\n<li>blocking the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber angle,</li>\n<li>leading to angle-closure glaucoma.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Leakage of lens proteins from a <span class=\"customMeta\" data-dictid=\"f534876b5b16927771891037555d81\">hypermature</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> clogs the trabecular meshwork.</li>\n</ul>\n<p><img alt=\"OP023\" data-author=\"\" data-hash=\"6608\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/3VWCzwPpyNM9Exy2jEOi1743620543.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Intumescent <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (mature cataract)</strong></li>\n<li>Anterior <span class=\"customMeta\" data-dictid=\"e53b153fb316927771996481a3e88f\">subluxation</span> of lens</li>\n<li>Spherophakia</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Hypermature (Morgagnian) <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong></li>\n<li>Obstruction of the trabecular <span class=\"customMeta\" data-dictid=\"21a7bbd1e416927771923570b66aad\">meshwork</span> by lens proteins.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Symptoms are similar to <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> primary angle-closure glaucoma.</li>\n<li><strong>Shallow <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</strong></li>\n<li>Ciliary congestion, dilated pupil, and swollen <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> is visible.</li>\n<li><strong>Closed <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber angle</strong> on gonioscopy.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Features of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"ba721aa6a6169277718506de6a226c\">congestive glaucoma</span> due to high IOP.</li>\n<li><strong>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</strong></li>\n<li><strong>Open <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber angle</strong> on gonioscopy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Medical Treatment</strong>: IV mannitol, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> acetazolamide, <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> beta-blockers.</li>\n<li><strong>Laser Iridotomy:</strong> To relieve angle closure.</li>\n<li><strong>Surgical Treatment: </strong>Cataract <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">extraction</span> with PCIOL implantation.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Medical Therapy:</strong> To lower IOP.</li>\n<li><strong>Surgical Treatment:</strong> <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">Extraction</span> of the <span class=\"customMeta\" data-dictid=\"f534876b5b16927771891037555d81\">hypermature</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> and PCIOL implantation.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6PVQH9KkkEK36GNBQMt71744813364.mp3", "video": ""}, {"text": "An 80-year-old female patient came with complaints of gradual progressive diminution of vision for 2 years in both her eyes. She reports that over the last year, she noticed an improvement in her ability to read without glasses. The following finding is seen on slit lamp examination over the right eye and the left eye has similar opacity. Choose the most appropriate course of management for this patient.", "options": [{"label": "A", "text": "Advise lifestyle modification and review after 3 months.", "correct": false}, {"label": "B", "text": "Recommend corticosteroids eye drops and reassess in 6 months.", "correct": false}, {"label": "C", "text": "Plan for Phacoemulsification.", "correct": true}, {"label": "D", "text": "Prescribe her rigid gas-permeable contact lenses.", "correct": false}], "correct_answer": "C. Plan for Phacoemulsification.", "question_images": ["https://image.prepladder.com/notes/G3ShAQJKueirQNWWu2kP1743620234.png"], "explanation_images": ["https://image.prepladder.com/notes/G3ShAQJKueirQNWWu2kP1743620234.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description and Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nuclear cataract/sclerosis- The <span class=\"customMeta\" data-dictid=\"4711a65634169277718737b781005d\">etiology</span> is nuclear sclerosis.</li>\n<li>Results from the gradual loss of lens <span class=\"customMeta\" data-dictid=\"d6c754309d16927771874142ec8ca4\">elasticity</span> and transparency due to dehydration, and increase in water-insoluble proteins.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Glare</li>\n<li>Diplopia</li>\n<li>Colored Halos</li>\n<li>Blurred Vision/ Gradual Vision Loss</li>\n<li>Black spots in front of eyes.</li>\n<li>Deterioration of vision:\n\t\t\t\t<ul>\n<li>In some patients with nuclear sclerosis,<strong> </strong><strong>near vision improves</strong> due to <strong>progressive index myopia</strong>.</li>\n<li>Such patients may have improvement in their near-vision glasses.</li>\n<li>This improvement in near vision is <span class=\"customMeta\" data-dictid=\"047f8930dd1692777197fed61e213c\">referred</span> to as <strong>'second sight.’</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grading</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Nuclear <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">Opacity</span> (NO): Ranges from 1 (slight opacification) to 5 (severe opacity).</li>\n<li>Nuclear Color (NC): Ranges from 1 (amber) to 5 (black).</li>\n<li><strong>Cataracta brunescens (amber-brown), Cataracta rubra (red), Cataracta <span class=\"customMeta\" data-dictid=\"f2fc45b6181692777193ed78c4835a\">nigra</span> (black)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Surgical measures: Mainstay of treatment.</li>\n<li>Cataract surgeries:\n\t\t\t\t<ul>\n<li>ICCE (not preferred now)</li>\n<li>ECCE</li>\n<li> SICS (Small Incision <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> Surgery)</li>\n<li> <strong>Phacoemulsification (most preferred)</strong></li>\n</ul>\n</li>\n<li>Followed by <span class=\"customMeta\" data-dictid=\"ffac6924ab16927771907dbb6fd7dd\">IOL</span> implantation: PC-IOL (Posterior chamber-intraocular lens) is preferred.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zKMLfn0kpe8rVIxyg3wf1744812849.mp3", "video": ""}, {"text": "A 70-year-old male patient comes to your clinic with complaints of glare and diminution of vision for 3 months. On examination, you notice the following appearance Choose the correct statement regarding the correct diagnosis.", "options": [{"label": "A", "text": "The Iris shadow test becomes positive only when the whole cortex is involved.", "correct": false}, {"label": "B", "text": "Patients see better in dark surroundings.", "correct": false}, {"label": "C", "text": "Characterized by saucer-shaped opacities in the center of the posterior cortex.", "correct": false}, {"label": "D", "text": "Vision loss occurs at a late stage.", "correct": true}], "correct_answer": "D. Vision loss occurs at a late stage.", "question_images": ["https://image.prepladder.com/notes/v1lZjohePuCKJOsZtuGs1743619886.png"], "explanation_images": ["https://image.prepladder.com/notes/v1lZjohePuCKJOsZtuGs1743619886.png", "https://image.prepladder.com/notes/2FFKpnL0ViCQkZmkD3pr1743620133.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Cataract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Impact</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cuneiform <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">Cortical</span> Cataract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Wedge-shaped opacities</strong> with clear areas in between.</li>\n<li>Extends from <strong>periphery to center</strong>.</li>\n<li>First appears in the lower <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> quadrant. Present in both <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> cortex.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> spoke-like pattern of opacities is seen.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Visual disturbances are noted at a comparatively late stage (since it starts at the periphery). <strong>(Option D)</strong></li>\n<li>Vision improves in bright light with contracted pupils. <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cupuliform <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">Cortical</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Saucer-shaped opacities</strong> are typically in the central part of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> (<strong>posterior <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataract).</strong> <strong>(Option C)</strong></li>\n<li>Extends from center to periphery.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Causes an early loss of visual acuity.- Due to the involvement of the nodal point</li>\n<li>Glares seen in PSC</li>\n<li>Better vision in dim light with dilated pupils.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:611px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. Stage of <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">Lamellar</span> Separation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Earliest stage of <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">senile</span> cataract</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Formation of vacuoles and water clefts within the cortex</li>\n<li>Reversible change</li>\n<li>Can only be demonstrated by <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp examination</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2. Stage of <span class=\"customMeta\" data-dictid=\"ecdf1a28291692777190b2a187346a\">Incipient</span> Cataract</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detectable opacities with clear areas present between. Causes visual disturbances.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cuneiform type:</strong></p>\n<ul>\n<li>Wedge-shaped opacities, extending from the <span class=\"customMeta\" data-dictid=\"2056156e8d169277718799b9e86725\">equator</span> appear as <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> spoke-like opacities.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cupuliform type:</strong></p>\n<ul>\n<li>Saucer-shaped <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> in the central <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3. <span class=\"customMeta\" data-dictid=\"c219021c491692777189d289f1fc03\">Immature</span> <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Progression of opacification</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Iris shadow visible </strong>(clear <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> visible) -Iris Shadow present here due to opacities + clear areas<strong>(Option A)</strong></li>\n<li>Can progress to <span class=\"customMeta\" data-dictid=\"efbe4dea2e1692777190fabea13765\">Intumescent</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> leading to the shallow <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4. <span class=\"customMeta\" data-dictid=\"0472620c171692777192c655af9c57\">Mature</span> <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> (aka <span class=\"customMeta\" data-dictid=\"efbe4dea2e1692777190fabea13765\">intumescent</span> cataract)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Complete <span class=\"customMeta\" data-dictid=\"990cbfd3111692777194c6967ee125\">opacification</span> of cortex</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The lens appears pearly white</li>\n<li>Referred to as a \"ripe cataract\"</li>\n<li>No <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> shadow as the whole lens is opacified with a chalky white color</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5. <span class=\"customMeta\" data-dictid=\"f534876b5b16927771891037555d81\">Hypermature</span> <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> (HMSC)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Advanced stage of <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> beyond maturity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Morgagnian <span class=\"customMeta\" data-dictid=\"f534876b5b16927771891037555d81\">Hypermature</span> Cataract: </strong></p>\n<ul>\n<li>Cortex liquefies</li>\n<li>Nucleus sinks to the bottom</li>\n<li>Bag of <span class=\"customMeta\" data-dictid=\"70da66640f16927771920de556da59\">milky</span> fluid appearance</li>\n</ul>\n<p><img alt=\"OP021\" data-author=\"\" data-hash=\"6606\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/2FFKpnL0ViCQkZmkD3pr1743620133.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sclerotic <span class=\"customMeta\" data-dictid=\"f534876b5b16927771891037555d81\">Hypermature</span> Cataract: </strong></p>\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> disintegrates, lens and <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> shrink.</li>\n<li>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</li>\n<li>Iridodonesis may be present.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vt5A6CsS8LQsHX2WeQMp1744274440.mp3", "video": ""}, {"text": "Which among the following is/are true statements regarding lens proteins? α/β/γ-Crystallins are water-soluble proteins Major intrinsic proteins contribute to lens transparency An increase in crystallins can lead to cataract β/γ-Crystallin family are the largest crystallins", "options": [{"label": "A", "text": "Only 1", "correct": false}, {"label": "B", "text": "1 &amp;amp; 2", "correct": true}, {"label": "C", "text": "2, 3 &amp;amp; 4", "correct": false}, {"label": "D", "text": "1, 2, 3 &amp;amp; 4", "correct": false}], "correct_answer": "B. 1 &amp; 2", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/9OOgIhf8jJFKmGp64svu1743619631.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zxZn7foE55JLXcqPeaQJ1744272512.mp3", "video": ""}, {"text": "What is the consequence of age-related decline in the Na+-K+ ATPase pump in the lens?", "options": [{"label": "A", "text": "Increased intralenticular K+ levels and decreased Na+ levels.", "correct": false}, {"label": "B", "text": "Increased intralenticular Na+ levels and decreased K+ levels.", "correct": true}, {"label": "C", "text": "Enhanced ion exchange efficiency.", "correct": false}, {"label": "D", "text": "Reduced intralenticular Ca2+ levels.", "correct": false}], "correct_answer": "B. Increased intralenticular Na+ levels and decreased K+ levels.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/oCLex9TMTdLWO8NeFy8f1743619510.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qValZ7NRQt7OD5WitVBq1744272055.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 43 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient with a long-standing history of diabetes presents with cataracts. Which of the following metabolic products is primarily responsible for cataract formation in this condition?", "options": [{"label": "A", "text": "Mannitol", "correct": false}, {"label": "B", "text": "Galactitol", "correct": false}, {"label": "C", "text": "Sorbitol", "correct": true}, {"label": "D", "text": "Fructose", "correct": false}], "correct_answer": "C. Sorbitol", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Ys19euRMGOTRwz9l6vlj1741021676.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "After the uneventful placement of an intraocular lens in a young patient during cataract surgery, what further steps should be taken?", "options": [{"label": "A", "text": "IOL replaced every 10 years", "correct": false}, {"label": "B", "text": "Never replaced", "correct": true}, {"label": "C", "text": "Relaced when secondary cataract develops Replaced when presbyopia develops", "correct": false}, {"label": "D", "text": "Replaced when presbyopia develops", "correct": false}], "correct_answer": "B. Never replaced", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the average degree of hypermetropia in a newborn?", "options": [{"label": "A", "text": "+2.5 D", "correct": true}, {"label": "B", "text": "+5 D", "correct": false}, {"label": "C", "text": "+10 D", "correct": false}, {"label": "D", "text": "+1 D", "correct": false}], "correct_answer": "A. +2.5 D", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - +2.5 D</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type of Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cause</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Axial Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Shortening of the eyeball's <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length. Commonest form.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Curvatural Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Flatter <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the cornea, lens, or both.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Index Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Decreased <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> index of the lens, usually due to <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> <span class=\"customMeta\" data-dictid=\"dae4dea0581692777198fdef9fa684\">sclerosis</span> in old age or in treated diabetics.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Positional Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Posterior <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Aphakia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Absence of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens, either <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> or <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> (e.g., after surgery), leads to high hypermetropia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Consecutive Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Overcorrected <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> after <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> surgery (e.g., LASIK, ICL) or underpowered <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> lens (IOL) after <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> surgery.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the most probable cause for the progressive vision loss in both eyes of a 25-year-old male who has been undergoing low-dose oral steroid therapy for the past decade?", "options": [{"label": "A", "text": "Cataract", "correct": true}, {"label": "B", "text": "Glaucoma", "correct": false}, {"label": "C", "text": "Cystoid macular edema", "correct": false}, {"label": "D", "text": "Retinal detachment", "correct": false}], "correct_answer": "A. Cataract", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - C\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "True statement regarding KF ring: Seen in all patient with neurological involvement Is pathognomonic for Wilson’s disease Resolves with desferroxamine Seen in all patients with hepatic involvement Seen in superior and inferior descemets membrane", "options": [{"label": "A", "text": "1 and 5", "correct": true}, {"label": "B", "text": "1,2 and 5", "correct": false}, {"label": "C", "text": "1,2,3,4 and 5", "correct": false}, {"label": "D", "text": "2,3,4 and 5", "correct": false}], "correct_answer": "A. 1 and 5", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the formula utilized to calculate the power of the lens during cataract surgery for a patient who has previously undergone LASIK for myopia?", "options": [{"label": "A", "text": "SRK 1", "correct": false}, {"label": "B", "text": "SRK 3", "correct": false}, {"label": "C", "text": "Hoffer Q", "correct": false}, {"label": "D", "text": "Haigis L", "correct": true}], "correct_answer": "D. Haigis L", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - Haigis L</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>SRK (Option A and B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hoffer Q (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Holladay I </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>P= A-2.5L-0.9K<br/>\n\t\t\t\t(L= <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length)<br/>\n\t\t\t\t(K= constant)</li>\n<li>Normal <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length (24 mm)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Short <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length (&lt;22mm)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Long <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length ( &gt;24.5 mm)</li>\n</ul>\n<p> </p>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old patient with progressive painless loss of vision presents to the ophthalmology OPD. The fundus image of the patient is given below. What could be the probable finding and the cause of it?", "options": [{"label": "A", "text": "Soft exudate, hypertension", "correct": false}, {"label": "B", "text": "Hard exudate, diabetes mellitus", "correct": true}, {"label": "C", "text": "Flame-shaped hemorrhages, hypertension", "correct": false}, {"label": "D", "text": "Soft exudate, central retinal vein occlusion", "correct": false}], "correct_answer": "B. Hard exudate, diabetes mellitus", "question_images": ["https://image.prepladder.com/notes/ARmNUKTSri38jjMY385F1746440234.png"], "explanation_images": ["https://image.prepladder.com/notes/t6B6zvhcMGDK7025c3l11746440370.png", "https://image.prepladder.com/notes/q01JlLnJqmINhAvTkuC91746440391.png"], "explanation": "<p>Correct Answer B - Hard exudate, diabetes mellitus</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Soft Exudates (Cotton-Wool Spots)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Hard Exudates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cloud-like, small, ill-defined, whitish patches</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Bright yellow, well-defined <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> deposits</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Formation Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Caused by <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">ischemia</span> and axonal swelling; <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">blockage</span> of axoplasmic flow</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Formed by leakage of fluid rich in proteins and lipids</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Superficial <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> layers, often seen around the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Seen around leaking microaneurysms, especially in the macula</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Common Shape</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Indistinct and variable; may change shape quickly</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Radial, star-shaped figure in the <span class=\"customMeta\" data-dictid=\"948746a830169277719140f9f93879\">macula</span> (macular fan/star)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Main Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Hypertensive <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> (Most common cause)</strong></li>\n<li>Diabetic retinopathy</li>\n<li>Toxemia of pregnancy</li>\n<li>Lupus erythematosus (LE)</li>\n<li>Polyarteritis nodosa (PAN)</li>\n<li>Retinopathy associated with AIDS</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Diabetic <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> (Most common cause) (Option B)</strong></li>\n<li>Hypertensive retinopathy</li>\n<li>Coats' disease</li>\n<li>Circinate retinopathy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"Soft Exudates\" data-author=\"Yinghua Fu a, Ge Zhang a, Xin Lu a, Honghan Wu b,Dawei Zhang \" data-hash=\"11911\" data-license=\"NA\" data-source=\"https://www.sciencedirect.com/science/article/abs/pii/S0957417423014896\" data-tags=\"May2025\" height=\"290\" src=\"https://image.prepladder.com/notes/t6B6zvhcMGDK7025c3l11746440370.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Severe NPDR\" data-author=\"Mona Leeza, Humera Farooq\" data-hash=\"11913\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Pathological-images-with-labelled-anomalies_fig1_332293685\" data-tags=\"May2025\" height=\"300\" src=\"https://image.prepladder.com/notes/q01JlLnJqmINhAvTkuC91746440391.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the surgical step shown in the image given below: [", "options": [{"label": "A", "text": "Hydrodissection", "correct": false}, {"label": "B", "text": "Capsulorrhexis", "correct": true}, {"label": "C", "text": "Intraocular lens implantation", "correct": false}, {"label": "D", "text": "Lens aspiration", "correct": false}], "correct_answer": "B. Capsulorrhexis", "question_images": ["https://image.prepladder.com/notes/Na3NrsJ0d5wz8WFJwVE31747058322.png"], "explanation_images": ["https://image.prepladder.com/notes/Na3NrsJ0d5wz8WFJwVE31747058322.png", "https://image.prepladder.com/content/271L4fLtAGFn5YJQ5ZSu1745576556.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Match the given images to their descriptions: 1. A. Posterior subcapsular cataract 2. B. Sunflower cataract 3. C. Morgagnian cataract 4. D. Snowflake cataract", "options": [{"label": "A", "text": "1A 2D 3B 4C", "correct": false}, {"label": "B", "text": "1D 2B 3A 4C", "correct": false}, {"label": "C", "text": "1B 2C 3D 4A", "correct": true}, {"label": "D", "text": "1C 2B 3D 4A", "correct": false}], "correct_answer": "C. 1B 2C 3D 4A", "question_images": ["https://image.prepladder.com/content/euIl1aalgcTC1rNBUHrJ1745920628.png", "https://image.prepladder.com/content/W3tyylrIt0Qn3TgJqJ8Z1745920628.png", "https://image.prepladder.com/content/0peqwe9HeUNZetilyXx21745920628.png", "https://image.prepladder.com/content/FPS2NQByX8PxAaLtKrsL1745920628.png"], "explanation_images": ["https://image.prepladder.com/content/G5vCOpkU0yX3mR1YlcvW1745920787.png", "https://image.prepladder.com/content/gxb7tiKhI2NazrDx8wEs1745920787.png", "https://image.prepladder.com/content/XRNa58CYiGtN86POYbEq1745920787.png", "https://image.prepladder.com/content/yXCkqwAsW6X2eDA2v4kC1745920787.png", "https://image.prepladder.com/content/PHdLUI93DqS1c7jzM0rJ1745920850.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>1.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Imrankabirhossain\" data-hash=\"\" data-license=\"CC BY-SA 4.0\" data-source=\"Sunflower cataract - Cataract - Wikipedia\" data-tags=\"\" height=\"363\" src=\"https://image.prepladder.com/content/G5vCOpkU0yX3mR1YlcvW1745920787.png\" width=\"447\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>B) <strong>Sunflower cataract:</strong></p>\n<ul>\n<li>Deposition of <strong>copper</strong> under the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> of the lens.</li>\n<li>Cause: <strong>Wilson's disease</strong></li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Amanda C. Maltry\" data-hash=\"\" data-license=\"CC BY-NC-ND 3.0\" data-source=\"Atlas Entry - Morgagnian cataract (uiowa.edu)\" data-tags=\"\" height=\"280\" src=\"https://image.prepladder.com/content/gxb7tiKhI2NazrDx8wEs1745920787.png\" width=\"446\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>C) Morgagnian cataract:</strong></p>\n<ul>\n<li>Seen in <strong>hypermature <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">senile</span> cataract</strong></li>\n<li>Cortex liquefies</li>\n<li><strong>Nucleus sinks to the bottom</strong></li>\n<li>Bag of <span class=\"customMeta\" data-dictid=\"70da66640f16927771920de556da59\">milky</span> fluid appearance</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>3.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"Open Access\" data-source=\"Figure 2 from Role of biochemical markers in type 2 diabetic patients of cataract and retinopathy attending Index Medical College, Hospital and Research Centre, Indore (M.P) | Semantic Scholar\" data-tags=\"\" height=\"354\" src=\"https://image.prepladder.com/content/XRNa58CYiGtN86POYbEq1745920787.png\" width=\"448\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>D) Snowflake cataract:</strong></p>\n<ul>\n<li>Also known as snowburst cataract</li>\n<li>Cause:<strong> Diabetes mellitus</strong></li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>4.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Imrankabirhossain\" data-hash=\"\" data-license=\"CC BY-SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Posterior_Subcapsular_Cataract.jpg\" data-tags=\"\" height=\"393\" src=\"https://image.prepladder.com/content/yXCkqwAsW6X2eDA2v4kC1745920787.png\" width=\"446\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>A) <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">Posterior</span> <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataract:</strong></p>\n<ul>\n<li>Opacity below the <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> in the central part of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> cortex.</li>\n<li>Causes:\n\t\t\t\t<ul>\n<li>Complicated cataract</li>\n<li>Blunt trauma</li>\n<li><strong>Myotonic <span class=\"customMeta\" data-dictid=\"04568e3d19169277718672d9da94fd\">dystrophy</span> (Christmas tree cataract)</strong></li>\n<li><strong>Glactosemia (Oil <span class=\"customMeta\" data-dictid=\"33843a1c3716927771867f807275d2\">droplet</span> cataract)</strong></li>\n<li>Drugs: <strong>Steroid</strong>, chloroquine, busulfan</li>\n</ul>\n</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Type of Cataract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Visual Impact</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cuneiform <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> Cortical Cataract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Wedge-shaped opacities</strong> with clear areas in between.</li>\n<li>Extends from <span class=\"customMeta\" data-dictid=\"316866040e1692777195f45393e010\">periphery</span> to center.</li>\n<li>First appears in the lower <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> quadrant. Present in both <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> cortex.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> spoke-like pattern of opacities is seen.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Visual disturbances are noted at a comparatively late stage (since it starts at the periphery).</li>\n<li>Vision improves in bright light with contracted pupils.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cupuliform <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> Cortical <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Saucer-shaped opacities</strong> are typically in the central part of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> <strong>(posterior <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataract)</strong>.</li>\n<li>Extends from center to periphery.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Causes an early loss of visual acuity.- Due to the involvement of the nodal point</li>\n<li><strong>Glares</strong> seen in PSC</li>\n<li>Better vision in dim light with dilated pupils.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:611px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>1. Stage of Lamellar Separation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Earliest stage of <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">senile</span> cataract</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Formation of vacuoles and water clefts within the cortex</li>\n<li>Reversible change</li>\n<li>Can only be demonstrated by <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp examination</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>2. Stage of Incipient Cataract</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Detectable opacities with clear areas present between. Causes visual disturbances.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cuneiform type:</strong></p>\n<ul>\n<li>Wedge-shaped opacities, extending from the <span class=\"customMeta\" data-dictid=\"2056156e8d169277718799b9e86725\">equator</span> appear as <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> spoke-like opacities.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cupuliform type:</strong></p>\n<ul>\n<li>Saucer-shaped <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> in the central <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>3. Immature <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Progression of opacification</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Iris shadow visible</strong> (clear <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> visible) -Iris Shadow present here due to opacities + clear areas</li>\n<li>Can progress to <span class=\"customMeta\" data-dictid=\"efbe4dea2e1692777190fabea13765\">Intumescent</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> leading to the shallow <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>4. <span class=\"customMeta\" data-dictid=\"0472620c171692777192c655af9c57\">Mature</span> <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> (aka <span class=\"customMeta\" data-dictid=\"efbe4dea2e1692777190fabea13765\">intumescent</span> cataract)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Complete <span class=\"customMeta\" data-dictid=\"990cbfd3111692777194c6967ee125\">opacification</span> of cortex</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The lens appears pearly white</li>\n<li>Referred to as a \"ripe cataract\"</li>\n<li><strong>No <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> shadow</strong> as the whole lens is opacified with a chalky white color</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>5. Hypermature <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> (HMSC)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Advanced stage of <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> beyond maturity</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Morgagnian Hypermature Cataract: </strong></p>\n<ul>\n<li>Cortex liquefies</li>\n<li><strong>Nucleus sinks to the bottom</strong></li>\n<li>Bag of <span class=\"customMeta\" data-dictid=\"70da66640f16927771920de556da59\">milky</span> fluid appearance</li>\n</ul>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"318\" src=\"https://image.prepladder.com/content/PHdLUI93DqS1c7jzM0rJ1745920850.png\" width=\"508\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sclerotic Hypermature Cataract: </strong></p>\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> disintegrates, lens and <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> shrink.</li>\n<li><strong>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</strong></li>\n<li>Iridodonesis may be present.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What substance is responsible for the development of a diabetic cataract in a 68-year-old female patient, which has been present for 3 months?", "options": [{"label": "A", "text": "Glucose", "correct": false}, {"label": "B", "text": "Fructose", "correct": false}, {"label": "C", "text": "Lactose + Glucose", "correct": false}, {"label": "D", "text": "Sorbitol", "correct": true}], "correct_answer": "D. Sorbitol", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - S\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 65-year-old diabetic woman presents with painless loss of vision. The ocular findings are shown in the image below. What is the likely diagnosis and management for this patient?", "options": [{"label": "A", "text": "Zonular cataract and lensectomy", "correct": false}, {"label": "B", "text": "Rosette cataract and sugar control", "correct": false}, {"label": "C", "text": "Sunflower cataract and lesion extraction", "correct": false}, {"label": "D", "text": "Immature senile cataract and phacoemulsification with IOL", "correct": true}], "correct_answer": "D. Immature senile cataract and phacoemulsification with IOL", "question_images": ["https://image.prepladder.com/notes/URe28TXKFEpLrTFTIQ1W1745909933.png"], "explanation_images": ["https://image.prepladder.com/content/IWP4nxdc9hpL8oFieEkK1745317430.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type of Cataract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Visual Impact</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cuneiform <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> Cortical Cataract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Wedge-shaped opacities</strong> with clear areas in between.</li>\n<li>Extends from <strong>periphery to center</strong>.</li>\n<li>First appears in the lower <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> quadrant. Present in both <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> cortex.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> spoke-like pattern of opacities is seen.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Visual disturbances are noted at a comparatively late stage (since it starts at the periphery).</li>\n<li>Vision improves in bright light with contracted pupils.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cupuliform <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> Cortical <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Saucer-shaped opacities</strong> are typically in the central part of the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> (<strong>posterior <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> cataract).</strong></li>\n<li>Extends from center to periphery.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Causes an early loss of visual acuity.- Due to the involvement of the nodal point</li>\n<li>Glares seen in PSC</li>\n<li>Better vision in dim light with dilated pupils.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Characteristics</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. Stage of Lamellar Separation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Earliest stage of <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">senile</span> cataract</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Formation of vacuoles and water clefts within the cortex</li>\n<li>Reversible change</li>\n<li>Can only be demonstrated by <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp examination</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2. Stage of Incipient Cataract</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detectable opacities with clear areas present between. Causes visual disturbances.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cuneiform type:</strong></p>\n<ul>\n<li>Wedge-shaped opacities, extending from the <span class=\"customMeta\" data-dictid=\"2056156e8d169277718799b9e86725\">equator</span> appear as <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> spoke-like opacities.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cupuliform type:</strong></p>\n<ul>\n<li>Saucer-shaped <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> in the central <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3. Immature <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Progression of opacification</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Iris shadow visible </strong>(clear <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> visible) -Iris Shadow present here due to opacities + clear areas</li>\n<li>Can progress to <span class=\"customMeta\" data-dictid=\"efbe4dea2e1692777190fabea13765\">Intumescent</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> leading to the shallow <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4. <span class=\"customMeta\" data-dictid=\"0472620c171692777192c655af9c57\">Mature</span> <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> (aka <span class=\"customMeta\" data-dictid=\"efbe4dea2e1692777190fabea13765\">intumescent</span> cataract)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Complete <span class=\"customMeta\" data-dictid=\"990cbfd3111692777194c6967ee125\">opacification</span> of cortex</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The lens appears pearly white</li>\n<li>Referred to as a \"ripe cataract\"</li>\n<li>No <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> shadow as the whole lens is opacified with a chalky white color</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5. Hypermature <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">Cataract</span> (HMSC)</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Advanced stage of <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> beyond maturity</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Morgagnian Hypermature Cataract: </strong></p>\n<ul>\n<li>Cortex liquefies</li>\n<li>Nucleus sinks to the bottom</li>\n<li>Bag of <span class=\"customMeta\" data-dictid=\"70da66640f16927771920de556da59\">milky</span> fluid appearance</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jesse Vislisel\" data-hash=\"\" data-license=\"CC BY-NC-ND 3.0\" data-source=\"Morgagnian cataract. EyeRounds.org: Online Ophthalmic Atlas (uiowa.edu)\" data-tags=\"\" height=\"184\" src=\"https://image.prepladder.com/content/IWP4nxdc9hpL8oFieEkK1745317430.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sclerotic Hypermature Cataract: </strong></p>\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> disintegrates, lens and <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> shrink.</li>\n<li>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</li>\n<li>Iridodonesis may be present.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What dye is used in staining for the anterior capsule of lens ?", "options": [{"label": "A", "text": "Trypan blue", "correct": true}, {"label": "B", "text": "Brilliant blue", "correct": false}, {"label": "C", "text": "Fluorescent green", "correct": false}, {"label": "D", "text": "Lissamine green", "correct": false}], "correct_answer": "A. Trypan blue", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"8275dbfca6169277720057579b2116\"&gt;Trypan Blue&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which type of cataract surgery is suturing with 10-0 nylon commonly performed?", "options": [{"label": "A", "text": "Phacoemulsification", "correct": false}, {"label": "B", "text": "Extracapsular cataract extraction (ECCE)", "correct": true}, {"label": "C", "text": "Intracapsular cataract extraction (ICCE)", "correct": false}, {"label": "D", "text": "Manual small incision cataract surgery (MSICS)", "correct": false}], "correct_answer": "B. Extracapsular cataract extraction (ECCE)", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"ab0f3917ce1692777187309ec78709\"&gt;Extracapsular&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\"&gt;cataract&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\"&gt;extraction&lt;/span&gt; (ECCE)\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which lens is utilized in direct gonioscopy?", "options": [{"label": "A", "text": "Goldmann", "correct": false}, {"label": "B", "text": "Koeppe", "correct": true}, {"label": "C", "text": "Zeiss", "correct": false}, {"label": "D", "text": "Sussman", "correct": false}], "correct_answer": "B. Koeppe", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which is the type of cataract seen following a blunt trauma?", "options": [{"label": "A", "text": "Rosette cataract", "correct": true}, {"label": "B", "text": "Christmas tree cataract", "correct": false}, {"label": "C", "text": "Snowflake cataract", "correct": false}, {"label": "D", "text": "Sunflower cataract", "correct": false}], "correct_answer": "A. Rosette cataract", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/hVll1cdRXTJTU6YfqyoQ1747217913.png", "https://image.prepladder.com/content/IZB5DddJwmTRvdn6Jzci1747217929.png", "https://image.prepladder.com/content/pVwJeev49ubiv9SyH5J51747217941.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Oil drop cataract is seen in?", "options": [{"label": "A", "text": "Galactosemia", "correct": true}, {"label": "B", "text": "Wilson's disease", "correct": false}, {"label": "C", "text": "Gaucher's disease", "correct": false}, {"label": "D", "text": "Tay-Sachs disease", "correct": false}], "correct_answer": "A. Galactosemia", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/itVEefSVifrG1DThunHU1747378530.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Galactosemia </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inborn error of <span class=\"customMeta\" data-dictid=\"99e53092e01692777188465c49d9b8\">galactose</span> metabolism</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Enzyme <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Galactose-1-phosphate uridyltransferase (GPUT)</li>\n<li>Galactokinase (GK)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Bilateral </strong></li>\n<li><strong>“Oil droplet” (Option A)</strong></li>\n<li><strong>Central lens </strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Anagha Medsinge, Ken K Nischal\" data-hash=\"\" data-license=\"CC BY-NC 4.0\" data-source=\"https://www.researchgate.net/figure/Oil-droplet-cataract-in-galactosemia_fig5_271331844\" data-tags=\"\" height=\"420\" src=\"https://image.prepladder.com/content/itVEefSVifrG1DThunHU1747378530.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>May be reversed </strong></li>\n<li>May be prevented if milk and milk products are eliminated at an early stage</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "After cataract surgery, a patient develops endophthalmitis with vision limited to hand movements. What is the treatment?", "options": [{"label": "A", "text": "Intravitreal antibiotic injections", "correct": true}, {"label": "B", "text": "Pars plana vitrectomy", "correct": false}, {"label": "C", "text": "Redo surgery", "correct": false}, {"label": "D", "text": "Topical antibiotics", "correct": false}], "correct_answer": "A. Intravitreal antibiotic injections", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/YuDBi8sxL29P7tflkhe91747306899.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Inflammation of inner structures of the eye (uveal tissue and retina) with exudates in the vitreous, anterior, and <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> chambers. It spares sclera.</li>\n<li><strong>Acute bacterial <span class=\"customMeta\" data-dictid=\"d7e86ebfd9169277718767de545052\">endophthalmitis</span> happens 1-7 days post <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> surgery</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>M/C <span class=\"customMeta\" data-dictid=\"f616aee08b169277718361438e1a91\">causative</span> organism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Staphylococcus epidermidis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Presentation </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> pain</li>\n<li>Redness</li>\n<li>Lacrimation</li>\n<li>Photophobia</li>\n<li>Loss of vision</li>\n<li>Red and swollen lids</li>\n<li>Conjunctival chemosis</li>\n<li>Circumcorneal congestion</li>\n<li>Cloudy cornea</li>\n<li>Ring infiltration</li>\n<li>Yellow necrotic wound edges</li>\n<li>Hypopyon</li>\n<li>Oedematous and muddy iris</li>\n<li>Yellow <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> due to <span class=\"customMeta\" data-dictid=\"0c02372a7d1692777196974ab1d772\">purulent</span> exudation</li>\n<li>Vitreous <span class=\"customMeta\" data-dictid=\"1f6bbb967d16927771871c1894ea2e\">exudation</span> which causes amaurotic cat's-eye reflex</li>\n<li>Raised <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure initially</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Intravitreal antibiotics (Option A)</strong>:\n\t\t\t\t<ul>\n<li>First choice: Vancomycin 1 mg + Ceftazidime 2.25 mg</li>\n<li>Second choice: Vancomycin 1 mg + Amikacin 0.4 mg</li>\n</ul>\n</li>\n<li><strong>Topical antibiotics (Option D)</strong></li>\n<li>Systemic antibiotics</li>\n<li>Steroid Therapy</li>\n<li>Supportive Therapy</li>\n<li><strong>Vitrectomy - if no improvement in 48-72 hours (Option B) or if severe infection with vision <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> to hand movements close to the face</strong></li>\n<li>If blind - no perception of light - Evisceration.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following cataracts is seen in blunt trauma?", "options": [{"label": "A", "text": "Rosette cataract", "correct": true}, {"label": "B", "text": "Toxic cataract", "correct": false}, {"label": "C", "text": "Metabolic cataract", "correct": false}, {"label": "D", "text": "Nuclear cataract", "correct": false}], "correct_answer": "A. Rosette cataract", "question_images": ["https://image.prepladder.com/content/65vOMJmTZ6DlljuZS8u61747305522.png"], "explanation_images": ["https://image.prepladder.com/content/HK9WeG4LrANScrK7iGai1747305701.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 2-month-old child is brought to the ophthalmology OPD with the following presentation. What is the ideal management?", "options": [{"label": "A", "text": "Medical management", "correct": false}, {"label": "B", "text": "Operate immediately", "correct": true}, {"label": "C", "text": "Surgery after 6 months", "correct": false}, {"label": "D", "text": "Surgery after 2 years", "correct": false}], "correct_answer": "B. Operate immediately", "question_images": ["https://image.prepladder.com/content/otp6QfQe1sIMWsNbK88p1724833060.png"], "explanation_images": [], "explanation": "<p>Correct Option B - O\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with decreased vision three years after surgery and exhibits this condition. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pseudo-bullous keratopathy", "correct": false}, {"label": "B", "text": "Corneal dystrophy", "correct": false}, {"label": "C", "text": "Posterior subcapsular cataract", "correct": false}, {"label": "D", "text": "Posterior capsular opacification (PCO)", "correct": true}], "correct_answer": "D. Posterior capsular opacification (PCO)", "question_images": ["https://image.prepladder.com/content/CginjMiduVaQSUnPIlbA1724830620.png"], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\"&gt;Posterior&lt;/span&gt; capsular &lt;span class=\"customMeta\" data-dictid=\"990cbfd3111692777194c6967ee125\"&gt;opacification&lt;/span&gt; (PCO)\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is Anisometropia?", "options": [{"label": "A", "text": "Difference in visual acuity", "correct": false}, {"label": "B", "text": "Difference in refractive error between 2 eyes", "correct": true}, {"label": "C", "text": "Difference in the axial length of the eyeball", "correct": false}, {"label": "D", "text": "Difference in the size of the eyeball", "correct": false}], "correct_answer": "B. Difference in refractive error between 2 eyes", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient, 36 hours after cataract surgery, presents with complaints of pain and visual disturbance . His eye is as shown below. What is the management of this condition?", "options": [{"label": "A", "text": "Intravenous steroids", "correct": false}, {"label": "B", "text": "Intravenous antibiotics", "correct": false}, {"label": "C", "text": "Bandage and padding of the eye", "correct": false}, {"label": "D", "text": "Intravitreal antibiotics", "correct": true}], "correct_answer": "D. Intravitreal antibiotics", "question_images": ["https://image.prepladder.com/content/f67iPJULeuYVjgjBGkFh1691453467.png"], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"67c9bce29d169277719036007848c0\"&gt;Intravitreal&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Rosette cataract is seen after?", "options": [{"label": "A", "text": "Blunt trauma to eye", "correct": true}, {"label": "B", "text": "Copper foreign body in eye", "correct": false}, {"label": "C", "text": "Penetrating injury to eye", "correct": false}, {"label": "D", "text": "Infection", "correct": false}], "correct_answer": "A. Blunt trauma to eye", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Blunt trau\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Ectopia lentis is seen in?", "options": [{"label": "A", "text": "Homocystinuria", "correct": true}, {"label": "B", "text": "Refsum's disease", "correct": false}, {"label": "C", "text": "Wilson's disease", "correct": false}, {"label": "D", "text": "Sarcoidosis", "correct": false}], "correct_answer": "A. Homocystinuria", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A -Homocystinu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the likely diagnosis for a 55-year-old male patient who visited the OPD with complaints of experiencing glare while driving at night, despite having cataract surgery a year ago? The patient's best corrected visual acuity is 6/12 in the right eye and 6/9 in the left eye, with no improvement observed when using a pinhole.", "options": [{"label": "A", "text": "Cystoid macular edema", "correct": false}, {"label": "B", "text": "Psudophakic bullous keratopathy", "correct": false}, {"label": "C", "text": "ARMD", "correct": false}, {"label": "D", "text": "Posterior capsular opacification", "correct": true}], "correct_answer": "D. Posterior capsular opacification", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Posterior capsu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "The person in the image is at the risk of developing?", "options": [{"label": "A", "text": "Exposure keratopathy", "correct": true}, {"label": "B", "text": "Restricted eye movements", "correct": false}, {"label": "C", "text": "Diplopia", "correct": false}, {"label": "D", "text": "Amblyopia", "correct": false}], "correct_answer": "A. Exposure keratopathy", "question_images": ["https://image.prepladder.com/content/PYUm5SGteaqc2WWMdeNo1745409438.png"], "explanation_images": ["https://image.prepladder.com/content/SyEzJBiyRjcBOKCwXQIz1745409519.png", "https://image.prepladder.com/content/zIXIaOc5I2eM4HBQR2uH1745409524.png", "https://image.prepladder.com/content/c7Vkc256cJgON2iVmK7Z1745409529.png", "https://image.prepladder.com/content/M6weBg1wvFFBjCVKJPtw1745409535.png", "https://image.prepladder.com/content/XZSgRTMzaBfJqNkK38gy1745409540.png"], "explanation": "<p>Correct Answer A - Exposure keratopathy</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Iris Coloboma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Pear-shaped <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> extending from the <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> but not always reaching the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body. It may occur alone or be associated with colobomata of the lens, choroid, or retina.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jmarchn\" data-hash=\"\" data-license=\"CC BY SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Coloboma#/media/File:Coloboma_of_the_iris.JPG\" data-tags=\"\" height=\"118\" src=\"https://image.prepladder.com/content/SyEzJBiyRjcBOKCwXQIz1745409519.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Coloboma of lens</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Notch-shaped <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> typically found along the <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> lens margin due to incomplete development of the <span class=\"customMeta\" data-dictid=\"f905752e7d169277719903de8a1ca9\">suspensory</span> ligament.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Doğan, Mustafa &amp; Polat, Onur &amp; Akcı, Onder &amp; Yavas, Güliz. \" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Lens-coloboma-right-eye-left-left-eye-right_fig2_284547899\" data-tags=\"\" height=\"155\" src=\"https://image.prepladder.com/content/zIXIaOc5I2eM4HBQR2uH1745409524.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fundus Coloboma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Oval or comet-shaped <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> with a rounded <span class=\"customMeta\" data-dictid=\"2d7ea2751316927771816ceb31afee\">apex</span> toward the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc, often with an irregularly depressed surface.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Mary Varghese ,JoelA Kavalakatt ,Shweta Pandey ,JerryJ Kolath\" data-hash=\"\" data-license=\"CC BY NC SA 4.0\" data-source=\"https://www.researchgate.net/figure/Fundus-picture-of-right-the-eye-showing-coloboma-inferior-to-optic-disc_fig1_294109531\" data-tags=\"\" height=\"194\" src=\"https://image.prepladder.com/content/c7Vkc256cJgON2iVmK7Z1745409529.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Coloboma of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Disc</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>It appears as an <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> at the lower edge of the disc due to incomplete <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> of the embryonic fissure.</li>\n<li>Found in Hypermetropic and Astigmatic eyes.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Bassi, Shikha &amp; George, Ronnie &amp; Sen, Swarnali &amp; Asokan, Rashima &amp; Vijaya, Lingam.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Optic-disc-coloboma-on-19-April-2018-by-guest-Protected-by-copyright_fig2_323954052\" data-tags=\"\" height=\"150\" src=\"https://image.prepladder.com/content/M6weBg1wvFFBjCVKJPtw1745409535.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Coloboma of Lid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Notch or gap in the <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> edge, most commonly on the upper lid, often associated with <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> <span class=\"customMeta\" data-dictid=\"39ab9251f916927771844eb7894e10\">coloboma</span> or <span class=\"customMeta\" data-dictid=\"9088e1c7f616927771802e7f6d2541\">accessory</span> auricles.</li>\n<li>The corneal surface cannot stay lubricated and hence can lead to exposure keratopathy.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Kator Chaha ,Sunday O Ajike\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"CC BY 4.0\" data-tags=\"\" height=\"179\" src=\"https://image.prepladder.com/content/XZSgRTMzaBfJqNkK38gy1745409540.png\" width=\"200\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What can be anticipated in angiography as a result of the lesion observed in the image, when a patient exhibits painless reduction in vision and metamorphopsia?", "options": [{"label": "A", "text": "Smoke – stack appearance", "correct": false}, {"label": "B", "text": "Inkblot appearance", "correct": false}, {"label": "C", "text": "Collarstud appearance", "correct": false}, {"label": "D", "text": "Double circulation", "correct": true}], "correct_answer": "D. Double circulation", "question_images": ["https://image.prepladder.com/content/DkpD3jZfY0A5w9fOaSbW1691496002.PNG"], "explanation_images": [], "explanation": "<p>Correct option D.\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 12 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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On examination, her intraocular pressure (IOP) is 48 mmHg, and there is a shallow anterior chamber with a hazy cornea. Slit-lamp examination reveals an intumescent, swollen lens with the iris pushed forward. Gonioscopy shows a closed angle. What is the most likely underlying mechanism for her glaucoma?", "options": [{"label": "A", "text": "Obstruction of the trabecular meshwork by inflammatory cells", "correct": false}, {"label": "B", "text": "Forward displacement of the lens due to an abnormal zonular attachment", "correct": false}, {"label": "C", "text": "Disruption of aqueous humor flow due to posterior synechiae", "correct": false}, {"label": "D", "text": "Pupillary block caused by the swollen lens", "correct": true}], "correct_answer": "D. Pupillary block caused by the swollen lens", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rE3F6zLbVfb6TBIjrFkk1746257926.mp3", "video": ""}, {"text": "Which of the following conditions is not typically associated with secondary congenital glaucoma?", "options": [{"label": "A", "text": "Aniridia", "correct": false}, {"label": "B", "text": "Marfan Syndrome", "correct": false}, {"label": "C", "text": "Turner Syndrome", "correct": false}, {"label": "D", "text": "Angel man syndrome", "correct": true}], "correct_answer": "D. Angel man syndrome", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Secondary Developmental/ <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> Glaucoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Associated <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">Ocular</span> Anomalies</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Associated <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">Systemic</span> Anomalies</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glaucoma Associated with Iridodysgenesis:</strong></p>\n<ul>\n<li>Aniridia (50% of cases) <strong>(Option A ruled out) </strong></li>\n<li>Familial <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">Iris</span> Hypoplasia</li>\n<li>Congenital <span class=\"customMeta\" data-dictid=\"410b701d9916927771861ac447b041\">Ectropion</span> Uvea</li>\n<li>Congenital Microcornea</li>\n<li>Congenital Nanophthalmos</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chromosomal Disorders:</strong></p>\n<ul>\n<li>Trisomy 13 (Patau Syndrome)</li>\n<li>Trisomy 18 (Edward’s Syndrome)</li>\n<li>Trisomy 21 (Down Syndrome)</li>\n<li>Turner Syndrome <strong>(Option C ruled out) </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ectopia Lentis Syndromes:</strong></p>\n<ul>\n<li>Marfan Syndrome <strong>(Option B ruled out) </strong></li>\n<li>Weill-Marchesani Syndrome</li>\n<li>Homocystinuria</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glaucoma Associated with <span class=\"customMeta\" data-dictid=\"30f118fb2c1692777190e03e0a6b8e\">Iridocorneal</span> Dysgenesis:</strong></p>\n<ul>\n<li><strong>Posterior Embryotoxon:</strong> Prominent Schwalbe's ring.</li>\n<li><strong>Axenfeld-Rieger Syndrome:</strong>\n<ul>\n<li><strong>Axenfeld Anomaly:</strong> <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">Posterior</span> <span class=\"customMeta\" data-dictid=\"c2b888cb12169277718701a117d5fb\">embryotoxon</span> with <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> tissue strands.</li>\n<li><strong>Rieger Anomaly:</strong> <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">Posterior</span> embryotoxon, <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> hypoplasia, <span class=\"customMeta\" data-dictid=\"410b701d9916927771861ac447b041\">ectropion</span> ,iris defects.</li>\n<li><strong>Rieger Syndrome:</strong> Rieger anomalies with dental, facial, and other <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> anomalies.</li>\n</ul>\n</li>\n<li><strong>Peter's Anomaly:</strong> Central corneal <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> with or without <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> or lens adhesions.</li>\n<li><strong>Combined Rieger’s Syndrome and Peter’s Anomaly:</strong> Features of both conditions.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phakomatosis :</strong></p>\n<ul>\n<li>Sturge-Weber Syndrome (50% of cases)</li>\n<li>Von Recklinghausen’s Neurofibromatosis<strong> </strong>(25% of cases)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metabolic Syndromes:</strong></p>\n<ul>\n<li>Lowe’s Syndrome: Oculocerebrorenal syndrome.</li>\n<li>Hurler’s Syndrome: Mucopolysaccharidosis.</li>\n<li>Zellweger Syndrome: Hepato-cerebral <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> syndrome.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AissQCSbYAlKcwRfAoBb1746417898.mp3", "video": ""}, {"text": "A 6-month-old infant with congenital glaucoma has corneal enlargement, clouding, and Haab’s striae and the angle is difficult to visualize due to corneal clouding. Which surgical procedure is most appropriate for this infant?", "options": [{"label": "A", "text": "Goniotomy", "correct": false}, {"label": "B", "text": "Trabeculotomy with Trabeculectomy", "correct": true}, {"label": "C", "text": "Trabeculectomy with antimetabolites", "correct": false}, {"label": "D", "text": "Glaucoma drainage devices", "correct": false}], "correct_answer": "B. Trabeculotomy with Trabeculectomy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/p1UPA6lZDRrlhYWS1p341742981352.png", "https://image.prepladder.com/notes/falx5mqeEyp6DOsXa5NA1742981297.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Eq7Pyp5Mea9Didw3GRVK1746418200.mp3", "video": ""}, {"text": "A 1-month-old child presents with persistent eye watering and light sensitivity. Examination shows enlarged corneas with Haab’s striae, cloudiness, a deep anterior chamber, and thin, blue sclera. The child has had ocular enlargement since birth. The ophthalmologist suspects congenital glaucoma. Which type of glaucoma best fits this presentation?", "options": [{"label": "A", "text": "Juvenile Glaucoma", "correct": false}, {"label": "B", "text": "Infantile Glaucoma", "correct": false}, {"label": "C", "text": "True Congenital Glaucoma", "correct": true}, {"label": "D", "text": "Secondary Congenital Glaucoma", "correct": false}], "correct_answer": "C. True Congenital Glaucoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zNl7UHVpeCrFtPnM1mdd1742980809.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> Glaucoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"04df903fe8169277719383126b1b02\">Newborn</span> glaucoma/ True <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> glaucoma</strong>: Elevated <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure is present during <span class=\"customMeta\" data-dictid=\"1d5d2712dc169277719050154d38a1\">intrauterine</span> life, resulting in <strong>ocular <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> at birth</strong>. (40% cases) <strong>(Option C)</strong></p>\n<p>Typically presents within the first month of life.</p>\n<p>Often associated with developmental anomalies of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> segment, such as primary <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> glaucoma, which can result from genetic mutations or other <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> conditions.</p>\n\t\t\t \n\n\t\t\t<p><strong>2. Infantile: ≤ 3 yrs of age</strong>- <strong>(Option B ruled out) </strong>Infantile <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> is labelled when the disease manifests prior to the child's third birthday</p>\n<p>Affects infants older than 1 month and children up to 3 years.</p>\n<p>Can also result from genetic factors or be secondary to other conditions like <span class=\"customMeta\" data-dictid=\"abe60030c41692777199de7c76674a\">Sturge-Weber syndrome</span> or other <span class=\"customMeta\" data-dictid=\"87356352bc169277719923fcc93329\">syndromic</span> associations.</p>\n<p><strong>3. Juvenile: &gt; 3 yrs of age</strong> <strong>(Option A ruled out) </strong>who develop pressure rise after 3 years but before adulthood. Also known as <span class=\"customMeta\" data-dictid=\"b5d5db1f591692777190869c6a7223\">Juvenile</span> primary open angle glaucoma(POAG) usually occurs between 10 to 35 years of age.</p>\n<p><strong>Buphthalmos</strong>, meaning \"bull-like eyes,\" is a condition characterized by the <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> of the eyeball. It typically manifests before the age of 3 years and results from the accumulation and <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Trabeculodysgenesis:</strong> <span class=\"customMeta\" data-dictid=\"bc408d83e0169277719161fedb67af\">Maldevelopment</span> of the trabeculum and iridotrabecular <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> from <span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\">neural</span> <span class=\"customMeta\" data-dictid=\"48528974ed1692777185cd29753db5\">crest</span> cells impairs <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> outflow, causing elevated IOP.</li>\n<li><strong>Angle <span class=\"customMeta\" data-dictid=\"e50e29a57b16927771978b2f6cff3e\">Recess</span> Absence:</strong> The angle <span class=\"customMeta\" data-dictid=\"e50e29a57b16927771978b2f6cff3e\">recess</span> is absent, with the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> inserting either flatly or concavely into the trabeculum.</li>\n<li><strong>Iris <span class=\"customMeta\" data-dictid=\"c88a7c1a0116927771909b2463968d\">Insertion</span> Types:</strong>\n<ul>\n<li><strong>Flat Insertion:</strong> Reveals the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body and scleral spur.</li>\n<li><strong>Concave Insertion:</strong> Obscures the <span class=\"customMeta\" data-dictid=\"d523549f091692777198f5ec70ed9e\">scleral spur</span> and <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong><u>Classic Triad:</u></strong> Lacrimation, photophobia, and blepharospasm; often accompanied by eye rubbing.</p>\n<p style=\"text-align:center\"><img alt=\"Congenital Glaucoma\" data-author=\"\" data-hash=\"1835\" data-license=\"\" data-source=\"\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/zNl7UHVpeCrFtPnM1mdd1742980809.png\"/></p>\n<p><strong><u>Corneal Signs:</u></strong></p>\n<ul>\n<li><strong>Oedema:</strong> Early sign, may progress to permanent opacity.</li>\n<li><strong>Enlargement:</strong> Corneal <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> &gt;13 mm confirms enlargement; &gt;16 mm indicates poor prognosis.</li>\n</ul>\n<p><strong>Haab’s Striae:</strong> <span class=\"customMeta\" data-dictid=\"1717bdb5d21692777200d45e31ceed\">Tears</span> in Descemet's membrane, visible as <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> lines.</p>\n\t\t\t \n\n\t\t\t<p><strong><u>Additional Features:</u></strong></p>\n<ul>\n<li><strong>Thin Sclera:</strong> Appears blue due to underlying uveal tissue.</li>\n<li><strong>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> Chamber:</strong> Indicates elevated IOP.</li>\n<li><strong>Iris Changes:</strong> <span class=\"customMeta\" data-dictid=\"da889be4d116927771901330eaf85a\">Iridodonesis</span> and atrophic patches in late stages.</li>\n<li><strong>Lens Changes:</strong> Becomes flat and may subluxate.</li>\n<li><strong>Optic Disc Changes:</strong> Variable <span class=\"customMeta\" data-dictid=\"4d57ccd00f1692777185c371df0426\">cupping</span> and atrophy.</li>\n<li><strong>Raised IOP:</strong> Elevated but not acute.</li>\n<li><strong>Axial Myopia:</strong> Due to increased <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/55kH2LqHV6oGJqdyzHfY1746418507.mp3", "video": ""}, {"text": "A 50-year-old glaucoma patient is prescribed a prostaglandin analog as first-line therapy. Which of the following is the most likely mechanism of action and a common side effect of this medication?", "options": [{"label": "A", "text": "Reduces aqueous humor production; Lid retraction", "correct": false}, {"label": "B", "text": "Increases trabecular outflow; Brow ache", "correct": false}, {"label": "C", "text": "Increases uveoscleral outflow; Iris pigmentation", "correct": true}, {"label": "D", "text": "Decreases aqueous humor secretion; Allergic blepharoconjunctivitis", "correct": false}], "correct_answer": "C. Increases uveoscleral outflow; Iris pigmentation", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pAIahrLDtMOfZ8w2oaGI1746422811.mp3", "video": ""}, {"text": "All of the following are penetrating glaucoma surgeries except:", "options": [{"label": "A", "text": "Trabeculectomy", "correct": false}, {"label": "B", "text": "Deep sclerectomy", "correct": true}, {"label": "C", "text": "Minimum incision glaucoma surgery", "correct": false}, {"label": "D", "text": "Glaucoma drainage device implantation", "correct": false}], "correct_answer": "B. Deep sclerectomy", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/b3apFiPkDq6AANiPhmIu1746262221.mp3", "video": ""}, {"text": "Which of the following laser procedures are used for Open angle glaucoma (OAG) and angle closure glaucoma (ACG) respectively?", "options": [{"label": "A", "text": "Argon laser iridotomy for open-angle glaucoma and selective laser trabeculoplasty (SLT) for angle closure glaucoma", "correct": false}, {"label": "B", "text": "Selective laser trabeculoplasty for open-angle glaucoma and laser iridotomy for angle closure glaucoma", "correct": true}, {"label": "C", "text": "Laser iridoplasty for open-angle glaucoma and argon laser iridotomy for angle closure glaucoma", "correct": false}, {"label": "D", "text": "Laser iridotomy for open-angle glaucoma and laser iridoplasty for angle closure glaucoma", "correct": false}], "correct_answer": "B. Selective laser trabeculoplasty for open-angle glaucoma and laser iridotomy for angle closure glaucoma", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mQiP5FJ0zrO0BeCvxduK1746261946.mp3", "video": ""}, {"text": "A 65-year-old male presents to the ophthalmology clinic for a routine eye examination. During the examination, his intraocular pressure (IOP) is measured at 28 mmHg in both eyes. The ophthalmologist diagnoses him with primary open-angle glaucoma. Which of the following medications is primarily designed to lower intraocular pressure by reducing the production of aqueous humor?", "options": [{"label": "A", "text": "Travoprost", "correct": false}, {"label": "B", "text": "Pilocarpine", "correct": false}, {"label": "C", "text": "Acetazolamide", "correct": true}, {"label": "D", "text": "Unoprostone", "correct": false}], "correct_answer": "C. Acetazolamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/0lVGMyV8Ctoa9OFtqVna1746261541.mp3", "video": ""}, {"text": "Which ICE syndrome is characterized by the presence of pigmented nodular lesions on the iris?", "options": [{"label": "A", "text": "Progressive iris atrophy", "correct": false}, {"label": "B", "text": "Chandler's syndrome", "correct": false}, {"label": "C", "text": "Cogan-Reese syndrome", "correct": true}, {"label": "D", "text": "Both A &amp;amp; C", "correct": false}], "correct_answer": "C. Cogan-Reese syndrome", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is false about traumatic glaucoma?", "options": [{"label": "A", "text": "Traumatic glaucoma can develop from both perforating and blunt injuries.", "correct": false}, {"label": "B", "text": "Angle recession glaucoma typically presents with elevated IOP shortly after the trauma.", "correct": true}, {"label": "C", "text": "Lens-induced glaucoma can occur due to a ruptured, swollen, or dislocated lens following trauma.", "correct": false}, {"label": "D", "text": "Peripheral anterior synechiae from corneal injury can lead to angle-closure glaucoma.", "correct": false}], "correct_answer": "B. Angle recession glaucoma typically presents with elevated IOP shortly after the trauma.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/gbVaq90c4dKOlJXxng431742976411.png", "https://image.prepladder.com/notes/lRcBDbquF5AjIkoeNYmL1742976431.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CFv64KYPCRQvu4Gk74zS1746260721.mp3", "video": ""}, {"text": "A 30-year-old male presents with unilateral eye discomfort, blurred vision, and seeing halos around lights. On examination, his intraocular pressure (IOP) is measured at 48 mm Hg. The anterior segment shows a few small, flat, nonpigmented keratic precipitates located inferiorly, mild redness, and an aqueous flare. The pupil is dilated, but there are no signs of a posterior synechiae. The patient reports recurrent episodes that resolve within days to weeks. Given these findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Secondary Angle-Closure Glaucoma with Pupillary Block", "correct": false}, {"label": "B", "text": "Secondary Angle-Closure Glaucoma without Pupillary Block", "correct": false}, {"label": "C", "text": "Open-Angle Glaucoma Due to Uveitis", "correct": false}, {"label": "D", "text": "Glaucomatocyclitic Crisis", "correct": true}], "correct_answer": "D. Glaucomatocyclitic Crisis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/IbM8kNJFSp4uAcSW0Rsp1742976186.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lZdIIaRqmbvEUgiEnL1q1746260190.mp3", "video": ""}, {"text": "A 70-year-old patient with a history of glaucoma undergoes a trabeculectomy to control intraocular pressure. Postoperatively, the patient presents with severe eye pain, blurred vision, a significantly elevated intraocular pressure (IOP), and a shallow anterior chamber. Seidel's test is negative. What is the most appropriate initial treatment for this condition?", "options": [{"label": "A", "text": "Oral corticosteroids", "correct": false}, {"label": "B", "text": "Pars plana Vitrectomy", "correct": false}, {"label": "C", "text": "Atropine drops and oral acetazolamide", "correct": true}, {"label": "D", "text": "Peripheral iridectomy", "correct": false}], "correct_answer": "C. Atropine drops and oral acetazolamide", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hbYgYW3CjwOitmv7mvAO1746423108.mp3", "video": ""}, {"text": "A 58-y/o diabetic patient presents with decreased vision, eye pain, and redness in the right eye. Examination reveals iris neovascularization, elevated intraocular pressure, and proliferative diabetic retinopathy. What is the most appropriate management strategy?", "options": [{"label": "A", "text": "Topical beta-blockers and oral carbonic anhydrase inhibitors", "correct": false}, {"label": "B", "text": "Panretinal photocoagulation", "correct": true}, {"label": "C", "text": "Systemic corticosteroids", "correct": false}, {"label": "D", "text": "VEGF inhibitors", "correct": false}], "correct_answer": "B. Panretinal photocoagulation", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/sC7A3IebevREdtgTroch1742975813.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3mYFh3G1qwx21FWgBrLw1748246573.mp3", "video": ""}, {"text": "A 55-year-old Asian woman presents with acute eye pain and blurred vision. Her ophthalmologist suspects primary angle closure glaucoma (PACG). Which of the following statements about the etiopathogenesis of PACG is incorrect?", "options": [{"label": "A", "text": "Pupillary block is the most common mechanism in PACG", "correct": false}, {"label": "B", "text": "Phacomorphic mechanism involves an abnormally large lens pushing the iris forward", "correct": false}, {"label": "C", "text": "Plateau iris configuration is more common in younger patients with PACG", "correct": false}, {"label": "D", "text": "Caucasians have a higher prevalence of PACG compared to other ethnicities", "correct": true}], "correct_answer": "D. Caucasians have a higher prevalence of PACG compared to other ethnicities", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mechanisms</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Demographic factors:</strong></p>\n<ul>\n<li>Age: 6th and 7th decades of life</li>\n<li>Gender: Female to male ratio 1:3</li>\n<li>Ethnicity: More common in Asians</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. Pupillary block (70% of cases): </strong><strong>(Option A ruled out)</strong></p>\n<ul>\n<li>Most common mechanism (70% of cases)</li>\n<li>Increased contact between <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> and lens</li>\n<li>Precipitating factors:\n\t\t\t\t<ul>\n<li>Physiological <span class=\"customMeta\" data-dictid=\"d37f6ac51016927771932ba05a49bc\">mydriasis</span> (e.g., dim illumination, emotional stress)</li>\n<li>Pharmacological <span class=\"customMeta\" data-dictid=\"d37f6ac51016927771932ba05a49bc\">mydriasis</span> (e.g., tropicamide, cyclopentolate)</li>\n</ul>\n</li>\n<li>Results in relative <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> block</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anatomical factors:</strong></p>\n<ul>\n<li>Hypermetropic eyes</li>\n<li>Shallow <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</li>\n<li>Short <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length</li>\n<li>Thick, anteriorly positioned lens</li>\n<li>Small corneal diameter</li>\n<li>Plateau <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> configuration</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2. <span class=\"customMeta\" data-dictid=\"7a4ced7da71692777195938424f299\">Plateau</span> <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> configuration: </strong></p>\n<ul>\n<li>Anteriorly positioned <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> processes</li>\n<li>More common in<strong> younger patients</strong><strong> (Option C ruled out)</strong></li>\n<li>Can persist after iridotomy</li>\n<li>Associated with angle <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> without pupillary block</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Other factors:</strong></p>\n<ul>\n<li>Family history</li>\n<li>Diabetes mellitus</li>\n<li>Certain medications (e.g., topiramate)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3. Phacomorphic mechanism: </strong><strong>(Option B ruled out)</strong></p>\n<ul>\n<li>Swollen lens contributes to angle closure</li>\n<li>Can cause pupillary block or push <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> forward</li>\n<li>Can occur in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> or chronic forms</li>\n<li>Associated with <span class=\"customMeta\" data-dictid=\"efbe4dea2e1692777190fabea13765\">intumescent</span> or other lens <span class=\"customMeta\" data-dictid=\"55beab619216927771925caac38373\">morphological</span> abnormalities</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/P26dmz5dAArzyYrs2mQr1746169798.mp3", "video": ""}, {"text": "A 72-year-old male presents with diminution of vision in the right eye. On slit-lamp examination, dandruff-like material is noted on the anterior lens capsule and iris. Intraocular pressure is elevated, and the patient is diagnosed with pseudoexfoliative glaucoma. Which of the following is most likely to be observed in this patient’s eye?", "options": [{"label": "A", "text": "Posterior synechiae", "correct": false}, {"label": "B", "text": "Zonular instability and phacodonesis", "correct": true}, {"label": "C", "text": "Corneal guttata", "correct": false}, {"label": "D", "text": "Iris heterochromia", "correct": false}], "correct_answer": "B. Zonular instability and phacodonesis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/A7UyVwcc6qz8E9CNau5z1746423672.mp3", "video": ""}, {"text": "A 25-year-old myopic male presents with intermittent blurring of vision and mild ocular pain after exercise. On examination, IOP is 28 mmHg, Slit lamp examination reveals Krukenberg spindle on corneal endothelium, trabecular pigmentation on gonioscopy. Which of the following is the first-line treatment?", "options": [{"label": "A", "text": "Nd:YAG laser peripheral iridotomy", "correct": false}, {"label": "B", "text": "Selective laser trabeculoplasty", "correct": false}, {"label": "C", "text": "Topical prostaglandin analogue", "correct": true}, {"label": "D", "text": "Argon laser peripheral iridoplasty", "correct": false}], "correct_answer": "C. Topical prostaglandin analogue", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xMWgb1gBqbUp0IoK9mPc1746255612.mp3", "video": ""}, {"text": "A 45-year-old male presents with unilateral eye pain, redness, and moderately elevated intraocular pressure (IOP) of 28 mmHg. On slit-lamp examination, you observe fine, pigmented deposits on the corneal endothelium in a vertical spindle pattern. The patient O/E has symmetric transillumination defects in the mid-peripheral iris. Based on these findings, which of the following is the most likely cause of this patient's secondary glaucoma?", "options": [{"label": "A", "text": "Pseudoexfoliation syndrome", "correct": false}, {"label": "B", "text": "Pigment dispersion syndrome", "correct": true}, {"label": "C", "text": "Neovascular glaucoma", "correct": false}, {"label": "D", "text": "Lens-particle glaucoma", "correct": false}], "correct_answer": "B. Pigment dispersion syndrome", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dqif6ZfznBQfrrxo5eoT1746198017.mp3", "video": ""}, {"text": "A 65-year-old male presents with a painful, blind right eye. On examination, the eye is stony hard with no light perception, 100% cupping of the optic disc, and a fixed, mid-dilated pupil. Which of the following is the correct initial management?", "options": [{"label": "A", "text": "Topical timolol and brimonidine", "correct": false}, {"label": "B", "text": "Trabeculectomy", "correct": false}, {"label": "C", "text": "Cyclodestructive procedure", "correct": true}, {"label": "D", "text": "Evisceration", "correct": false}], "correct_answer": "C. Cyclodestructive procedure", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XFzcrdHL3303xC8dBgMu1746197581.mp3", "video": ""}, {"text": "All of the following components of Vogt's triad are typically observed in a patient who has experienced and resolved an acute primary angle-closure glaucoma (APAC) attack except?", "options": [{"label": "A", "text": "Glaucoma fleken", "correct": false}, {"label": "B", "text": "Iris atrophy", "correct": false}, {"label": "C", "text": "Pigment dispersion", "correct": false}, {"label": "D", "text": "Progressive retinal damage", "correct": true}], "correct_answer": "D. Progressive retinal damage", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old female presents for a routine eye examination. During gonioscopy, the examination reveals an occludable anterior chamber angle bilaterally. The patient reports no visual symptoms, and intraocular pressure (IOP) measurements are within normal limits. There is no evidence of glaucomatous damage on optic nerve examination. What is the most appropriate next step in management for this patient?", "options": [{"label": "A", "text": "I.V Mannitol/Acetazolamide", "correct": false}, {"label": "B", "text": "Prophylactic peripheral iridotomy", "correct": true}, {"label": "C", "text": "Filtration surgery", "correct": false}, {"label": "D", "text": "Topical beta-blocker therapy", "correct": false}], "correct_answer": "B. Prophylactic peripheral iridotomy", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VqT9sFqUI7Ox2xvfB57v1745227013.mp3", "video": ""}, {"text": "What aspect of the anterior chamber does the Van Herick grading system evaluate during slit lamp examination?", "options": [{"label": "A", "text": "The curvature of the cornea", "correct": false}, {"label": "B", "text": "The width of the anterior chamber angle", "correct": true}, {"label": "C", "text": "The condition of the retina", "correct": false}, {"label": "D", "text": "The intraocular pressure", "correct": false}], "correct_answer": "B. The width of the anterior chamber angle", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:503px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Width of the empty space (LACD) as compared to the corneal thickness</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>VAN Herick Grade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Angle status</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No black space observed</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Closed</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt;¼ corneal thickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extremely narrow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>¼ of corneal thickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Narrow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;¼ to ½ of corneal thickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>≥ 1/2 of corneal thickness</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Wide open</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5QRvzDUxDg3Ze5pLppkW1746174658.mp3", "video": ""}, {"text": "In the Shaffer classification system for grading the anterior chamber angle, which grade indicates that the angle is fully open with visible structures such as the scleral spur and trabecular meshwork?", "options": [{"label": "A", "text": "Grade 0", "correct": false}, {"label": "B", "text": "Grade 1", "correct": false}, {"label": "C", "text": "Grade 2", "correct": false}, {"label": "D", "text": "Grade 3", "correct": true}], "correct_answer": "D. Grade 3", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>ACA in degrees</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>ACA grade</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Angle status</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Visible structures</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>0</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Closed</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No structures visible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt;/= 10</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extremely narrow</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Schwalbe’s line</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>11-19</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Narrow</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trabecular meshwork</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>20-34</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Open</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Scleral spur</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>35-45</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Wide open</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ciliary body</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/t6fHIt4rmcuKpux0voHL1746174108.mp3", "video": ""}, {"text": "Which of the following best describes the principle of gonioscopy?", "options": [{"label": "A", "text": "It involves measuring intraocular pressure.", "correct": false}, {"label": "B", "text": "It is a technique for visualizing the anterior chamber angle of the eye using a special lens", "correct": true}, {"label": "C", "text": "It is a technique for visualizing the posterior chamber angle of the eye using a special lens", "correct": false}, {"label": "D", "text": "It evaluates the retina.", "correct": false}], "correct_answer": "B. It is a technique for visualizing the anterior chamber angle of the eye using a special lens", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/3oTYLcf419WeekPutEns1742972492.png", "https://image.prepladder.com/notes/Eqr8JCbtCZn4rPV7tY1A1742972775.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/naj5MttNL3gyuXFDfeeJ1746173797.mp3", "video": ""}, {"text": "A 35-year-old woman presents with intermittent eye pain and blurred vision. Gonioscopy reveals narrow angles, and the angle remains narrow after laser peripheral iridotomy. Which of the following statements about plateau iris configuration is incorrect ?", "options": [{"label": "A", "text": "It is characterized by an anteriorly positioned ciliary body", "correct": false}, {"label": "B", "text": "It is more commonly seen in older patients with primary angle closure glaucoma", "correct": true}, {"label": "C", "text": "Plateau iris configuration can persist after iridotomy", "correct": false}, {"label": "D", "text": "Ultrasound biomicroscopy (UBM) can be useful in diagnosing this condition", "correct": false}], "correct_answer": "B. It is more commonly seen in older patients with primary angle closure glaucoma", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anatomy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Plateau <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> is characterized by an anteriorly positioned <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body, which pushes the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> forward.</li>\n<li>This creates a <strong>\"table-top\"</strong> or <strong>plateau-like appearance</strong> of the iris.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Age of presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is more commonly seen in<strong> younger patients</strong> with primary angle <span class=\"customMeta\" data-dictid=\"2b4569285f1692777184282b1ca3f1\">closure</span> glaucoma.</li>\n<li>This is in contrast to the pupillary block, which is more common in older individuals.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnostic tools</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Ultrasound <span class=\"customMeta\" data-dictid=\"5eeb78465e1692777183b11db65160\">biomicroscopy</span> (UBM) </strong>is particularly useful in diagnosing <span class=\"customMeta\" data-dictid=\"7a4ced7da71692777195938424f299\">plateau</span> <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> configuration. <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Due to its <strong>persistence after iridotomy,</strong> patients with <span class=\"customMeta\" data-dictid=\"7a4ced7da71692777195938424f299\">plateau</span> <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> may require additional treatments such as: <strong>(Option C)</strong>\n<ul>\n<li>Argon laser <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> iridoplasty</li>\n<li>Long-term use of <span class=\"customMeta\" data-dictid=\"e118c4868f1692777192e0e253b24c\">miotic</span> drops</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mia6lJcoKFBmyvIenEKI1746171791.mp3", "video": ""}, {"text": "A 50-year-old patient presents with symptoms suggesting possible angle-closure glaucoma. You want to perform a comprehensive assessment of the anterior chamber angle. Which of the following statements is incorrect regarding anterior chamber angle assessment and anatomy?", "options": [{"label": "A", "text": "Gonioscopy is the definitive diagnostic tool for primary angle closure.", "correct": false}, {"label": "B", "text": "Normal angle structures from anterior to posterior include: Schwalbe's line, non-pigmented trabecular meshwork, pigmented trabecular meshwork, scleral spur, and ciliary body band.", "correct": false}, {"label": "C", "text": "An angle is considered occludable if the pigmented trabecular meshwork is not visible in less than 180 degrees without indentation.", "correct": true}, {"label": "D", "text": "Indirect gonioscopes used to measure angle of AC are goldmann, posner-ritch, zeiss", "correct": false}], "correct_answer": "C. An angle is considered occludable if the pigmented trabecular meshwork is not visible in less than 180 degrees without indentation.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/tZBrj62DkDYvJPbJ4TKX1742971882.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Indirect (Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Direct </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Provides a <span class=\"customMeta\" data-dictid=\"0a204240bd1692777192efdfa9e07d\">mirror image</span> of the opposite angle</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Provides a direct view of the angle</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Example : </strong></p>\n\t\t\t \n\n\t\t\t<p>1. Goldmann lenses</p>\n<ul>\n<li>Single mirror</li>\n<li>Surger</li>\n<li>Two mirror</li>\n<li>Three mirror</li>\n</ul>\n<p>2. Zeiss</p>\n<p>3. Susman</p>\n<p>4. Posner – Ritch</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Example: </strong></p>\n\t\t\t \n\n\t\t\t<p>1. Koeppe</p>\n<p>2. Swan – Jacob</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fPlfqFE2Kg5ua0RNo7G71746170455.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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// Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Match the following: 1) Perkins Tonometer a) 2) Tonopen b) 3) Pulsair tonometer c) 4) Rebound Tonometer d)", "options": [{"label": "A", "text": "1-a, 2-c, 3-d, 4-b", "correct": false}, {"label": "B", "text": "1-c, 2-b, 3-d, 4-a", "correct": false}, {"label": "C", "text": "1-d, 2-a, 3-b, 4-c", "correct": true}, {"label": "D", "text": "1-c, 2-d, 3-a, 4-b", "correct": false}], "correct_answer": "C. 1-d, 2-a, 3-b, 4-c", "question_images": ["https://image.prepladder.com/notes/nuGqqWqqXqF6dPF7rybu1743749764.png", "https://image.prepladder.com/notes/8YU49ds4gAFMKKm8gkW41743749785.png", "https://image.prepladder.com/notes/k6FoVpCDlpABq2EmBLAs1743749808.png", "https://image.prepladder.com/notes/6pCgRtxvkzBxcE4bRtA61743749827.png"], "explanation_images": ["https://image.prepladder.com/notes/lEAXpFQ5UnlhokPTqpEF1743750349.png", "https://image.prepladder.com/notes/S4FXA3IbZZ0qEOeNSrPr1743750367.png", "https://image.prepladder.com/notes/tR99irb0LEpL7pIkDHtC1743750383.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Perkin's <span class=\"customMeta\" data-dictid=\"bae4a70e581692777181bcd2593bf6\">applanation</span> tonometer</strong></p>\n<ul>\n<li>It is portable and does not require a <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp, but accurate readings need significant practice.</li>\n<li>Hand held version of Goldmann.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Perkin's &lt;span class=\" custommeta\"=\"\" data-dictid=\"bae4a70e581692777181bcd2593bf6\"/>applanation <span class=\"customMeta\" data-dictid=\"483dec41891692777200500d008fb8\">tonometer</span> (labeled)\" data-author=\"Paolo Brusini ,Maria Letizia Salvetat and Marco Zeppieri \" data-hash=\"7268\" data-license=\"CC BY\" data-source=\"https://www.mdpi.com/2077-0383/10/17/3860\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uAzZf1Uju74flT4VwbUm1743750272.png\" /&gt;\n\t\t\t<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pulsair (non-contact tonometer)</strong></p>\n<ul>\n<li>A noncontact device that measures <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Pulsair (non-contact) tonometer(labeled)\" data-author=\"Paolo Brusini ,Maria Letizia Salvetat and Marco Zeppieri \" data-hash=\"7269\" data-license=\"CC BY\" data-source=\"https://www.mdpi.com/2077-0383/10/17/3860\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/lEAXpFQ5UnlhokPTqpEF1743750349.png\">\n<figcaption>{{caption_text}}</figcaption>\n</img></figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tonopen (based on both <span class=\"customMeta\" data-dictid=\"cdb5523e491692777190f8bc3775ff\">indentation</span> and applanation)</strong></p>\n<ul>\n<li>A portable, computerized <span class=\"customMeta\" data-dictid=\"483dec41891692777200500d008fb8\">tonometer</span> that uses a <span class=\"customMeta\" data-dictid=\"79067cb33316927771926965c3c0b5\">microscopic</span> <span class=\"customMeta\" data-dictid=\"f3d6ae0bcd16927772005689a33dba\">transducer</span> to applanate the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and convert <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure into electronic signals.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Tonopen (labeled)\" data-author=\"J. RajeshPragathi PrasannaR. AkshithT. ManjunathG. Pavithra\" data-hash=\"7270\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Conceptual-view-of-a-smart-tonopen-for-biomedical-Rajesh-Prasanna/d933516b828f8eddc63a7fae5a35581e431a7537/figure/2\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/S4FXA3IbZZ0qEOeNSrPr1743750367.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rebound tonometer</strong></p>\n<ul>\n<li>Used for self-measurement</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Rebound tonometer(labeled)\" data-author=\"Paolo Brusini ,Maria Letizia Salvetat and Marco Zeppieri \" data-hash=\"7271\" data-license=\"CC BY\" data-source=\"https://www.mdpi.com/2077-0383/10/17/3860\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/tR99irb0LEpL7pIkDHtC1743750383.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yPTkG0stPI69m11PVi1N1745226619.mp3", "video": ""}, {"text": "A 62-year-old man with a history of Glaucoma undergoes visual field testing to assess his peripheral vision. The test involves moving a stimulus of constant size and intensity from a non-seeing area into a seeing area to determine the boundaries of his visual field. Which type of perimetry is being described?", "options": [{"label": "A", "text": "Goldmann perimetry", "correct": true}, {"label": "B", "text": "Automated perimetry", "correct": false}, {"label": "C", "text": "Frequency doubling perimetry", "correct": false}, {"label": "D", "text": "Short-wavelength automated perimetry", "correct": false}], "correct_answer": "A. Goldmann perimetry", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/54hFrr7amAS0kNvhyofJ1743754310.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Confrontation method</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Confrontation <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> testing involves having the patient look directly at the examiner's eye or nose.</li>\n<li>It compares the <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> of the patient and the physician.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lister's perimetry</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It has a <span class=\"customMeta\" data-dictid=\"84433cae211692777192a484f539bc\">metallic</span> semicircular arc, graded in degrees, with a white dot for <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> in the center.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"2207398c591692777182d7ac096dbc\">arc</span> can be rotated in different meridians.</li>\n<li>It is useful for <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> field charting. Not used nowadays</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tangent screen <span class=\"customMeta\" data-dictid=\"31cf3d043e1692777198d2cdd1089a\">scotometry</span> (Bjerrum Screen)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It is useful to evaluate the central and <span class=\"customMeta\" data-dictid=\"fcf447f5781692777194d3d1d4e7e5\">paracentral</span> area (30°) of the visual field</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Goldmann's perimetry</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>lt consists of a hemispherical dome.</li>\n<li>Its main advantage over the <span class=\"customMeta\" data-dictid=\"b23cdb8f4f1692777200dd5469ae3a\">tangent screen</span> is that the test conditions and the intensity of the target are always the same.</li>\n<li>It permits greater reproducibility.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/B1oNs1GcWaK3iNb546M61746956471.mp3", "video": ""}, {"text": "A 55-year-old patient with primary open-angle glaucoma undergoes visual field testing. Which of the following visual field defects is considered the earliest clinically significant field defect occurring in glaucoma?", "options": [{"label": "A", "text": "No options available", "correct": false}], "correct_answer": "Unknown", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/cRZQpzjRWifwSOsOYeuT1743753652.png", "https://image.prepladder.com/notes/yOexHx5GXBV2ADsZkwXu1743753683.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"eb0227679c16927771906b997f4646\">Isopter</span> contraction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild generalized <span class=\"customMeta\" data-dictid=\"4880e9b3761692777185e64eba797c\">constriction</span> of central as well as <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> field</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2. Baring of blind spot</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Early glaucomatous change, but <span class=\"customMeta\" data-dictid=\"70d4f989c31692777193372189cfbb\">nonspecific</span> and of limited <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> value</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3. Small ring-shaped <span class=\"customMeta\" data-dictid=\"fcf447f5781692777194d3d1d4e7e5\">paracentral</span> scotoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Earliest clinically significant field defect; appears in Bjerrum's area</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4. Seidel's scotoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Paracentral <span class=\"customMeta\" data-dictid=\"a685fb1a5716927771982efa29a365\">scotoma</span> joins the <span class=\"customMeta\" data-dictid=\"20fdb467921692777183b457fca572\">blind spot</span> to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> a sickle-shaped defect</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5. <span class=\"customMeta\" data-dictid=\"734bdc6ddd1692777182e15cb76ca5\">Arcuate</span> or Bjerrum's scotoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Formed at a later stage by extension of Seidel's <span class=\"customMeta\" data-dictid=\"a685fb1a5716927771982efa29a365\">scotoma</span> in an area above or below the <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> point</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>6. Ring or double <span class=\"customMeta\" data-dictid=\"734bdc6ddd1692777182e15cb76ca5\">arcuate</span> scotoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Develops when the two <span class=\"customMeta\" data-dictid=\"734bdc6ddd1692777182e15cb76ca5\">arcuate</span> scotomas join together</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>7. Roenne's central <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> step</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>An area of depression above or below the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> on the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> side. This is due to the two <span class=\"customMeta\" data-dictid=\"734bdc6ddd1692777182e15cb76ca5\">arcuate</span> scotomas running in different arcs and meet to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> a sharp right-angled gap.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>8. <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">Peripheral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> step</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Appear sometimes at an early stage; <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> step results from unequal <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> of the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> isopter</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>9. Advanced glaucomatous field defects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Visual field loss gradually spreads peripherally, eventually only the central and <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> island of vision is left behind.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/suvt9LiZ8bjlwKP2e5651746955973.mp3", "video": ""}, {"text": "A 55-year-old patient undergoes a comprehensive eye examination including visual field testing. Which of the following statements is incorrect?", "options": [{"label": "A", "text": "A scotoma is an area of decreased vision surrounded by normal vision", "correct": false}, {"label": "B", "text": "An isopter is a line connecting points of equal light sensitivity and size detection in the visual field", "correct": false}, {"label": "C", "text": "The blind spot is a type of absolute scotoma", "correct": false}, {"label": "D", "text": "The visual field extends maximally in the superior direction", "correct": true}], "correct_answer": "D. The visual field extends maximally in the superior direction", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/v40vMJlwLnLJs1YGhTmy1746955673.mp3", "video": ""}, {"text": "A 58-year-old patient is being evaluated for suspected primary open-angle glaucoma. The ophthalmologist wants to perform a thorough examination of the optic nerve head to detect glaucomatous changes. Which of the following techniques is considered the examination of choice for evaluating fundus changes in this patient?", "options": [{"label": "A", "text": "Direct ophthalmoscopy", "correct": false}, {"label": "B", "text": "Slit-lamp biomicroscopic examination with non-contact lens", "correct": true}, {"label": "C", "text": "Optical coherence tomography (OCT)", "correct": false}, {"label": "D", "text": "Indirect ophthalmoscopy", "correct": false}], "correct_answer": "B. Slit-lamp biomicroscopic examination with non-contact lens", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Slit Lamp Biomicroscopy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Investigation of choice</strong></li>\n<li>Lenses used:</li>\n</ul>\n<p><strong>Contact Lens:</strong> Goldman three mirror</p>\n<p><strong>Non Contact Lens:</strong> <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">Convex</span> ( +78D, +90D) or <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">Concave</span> (Hruby Lens)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct Ophthalmoscopy</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>No <span class=\"customMeta\" data-dictid=\"86dca0a89d169277718659b013c630\">depth perception</span> as the examiner uses only one eye.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indirect Ophthalmoscopy</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Magnification is less, hence it is not used to examine the disc and macula.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>OCT (Optical coherence tomography) </strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Useful method to measure <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc diameter, CDR, NRR <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc area</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scanning Laser Polarimetry</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Nerve fiber analyzer</strong>- To measure <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> of nerve fiber layer</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HRd913sxDxqQaVxDs9cK1746955060.mp3", "video": ""}, {"text": "A 62-year-old woman with a family history of glaucoma presents with mild visual disturbances. Her intraocular pressure is measured to be 24 mmHg in both eyes. On dilated fundus examination, the following findings are noted: The cup-to-disc ratio of 0.5 Splinter hemorrhages at the optic disc margin Wedge-shaped retinal nerve fiber layer defects on red-free light examination What stage of glaucomatous optic disc changes is most likely present in this patient?", "options": [{"label": "A", "text": "Glaucomatous optic atrophy", "correct": false}, {"label": "B", "text": "Advanced glaucomatous changes", "correct": false}, {"label": "C", "text": "Early glaucomatous changes", "correct": true}, {"label": "D", "text": "Physiological cupping", "correct": false}], "correct_answer": "C. Early glaucomatous changes", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UqQar03VTFsl5OEy5J4e1746954609.mp3", "video": ""}, {"text": "A 58-year-old woman with a long history of untreated open-angle glaucoma presents with gradual peripheral vision loss. Fundoscopic examination reveals advanced optic disc cupping. Which of the following vascular changes is most characteristic of progressive glaucomatous optic neuropathy?", "options": [{"label": "A", "text": "Inferior displacement of retinal vessels", "correct": false}, {"label": "B", "text": "Nasal displacement of retinal vessels", "correct": true}, {"label": "C", "text": "Arterial attenuation with increased vein diameter", "correct": false}, {"label": "D", "text": "Radial peripapillary capillary obliteration", "correct": false}], "correct_answer": "B. Nasal displacement of retinal vessels", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/N3LLCDmbbf5CJBL3Nw1J1746953785.mp3", "video": ""}, {"text": "A 58-year-old male with a family history of glaucoma presents for a comprehensive eye exam. His visual acuity is 20/20 in both eyes, and his intraocular pressure (IOP) is measured at 23 mmHg in the right eye and 21 mmHg in the left eye. Fundoscopic examination reveals the following optic disc findings in the right eye: Cup-to-disc ratio: 0.7 vertically Neuroretinal rim thinning: More pronounced in the superior and inferior quadrants Peripapillary atrophy present No optic disc hemorrhages noted All of the following statements are correct regarding the optic disc assessment in this patient except?", "options": [{"label": "A", "text": "The optic disc appearance follows the ISNT rule, indicating a healthy optic nerve.", "correct": true}, {"label": "B", "text": "The cup-to-disc ratio indicates early glaucomatous damage.", "correct": false}, {"label": "C", "text": "The absence of optic disc hemorrhages does not rule out glaucoma.", "correct": false}, {"label": "D", "text": "Peripapillary atrophy is commonly associated with glaucoma and warrants further monitoring.", "correct": false}], "correct_answer": "A. The optic disc appearance follows the ISNT rule, indicating a healthy optic nerve.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Xam9DluIPUzlnO8Gybx61747028937.png", "https://image.prepladder.com/notes/6HWYcbytIvjj5Aw2am9i1743752037.png", "https://image.prepladder.com/notes/2SD7BMquPtVKqL2GSJu21743752056.png", "https://image.prepladder.com/notes/d4bLNevVqtN6j0HmT9YO1743752068.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pwGVRHpsj5SNpl8zggJG1746953364.mp3", "video": ""}, {"text": "Which device is a non contact tonometer that is based on the principle of corneal hysteresis?", "options": [{"label": "A", "text": "Schiotz tonometer", "correct": false}, {"label": "B", "text": "Goldmann applanation tonometer", "correct": false}, {"label": "C", "text": "Ocular Response Analyzer", "correct": true}, {"label": "D", "text": "Pneumatonometer", "correct": false}], "correct_answer": "C. Ocular Response Analyzer", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zfBPws1PtWgskDvME58u1743750883.png", "https://image.prepladder.com/notes/T0WhNtRhHAeeXvW7mawV1743750982.png", "https://image.prepladder.com/notes/2guQBMYSUjV62fnuE3KG1743751030.png", "https://image.prepladder.com/notes/iTIJSVxi2Zsy5CLUCAEs1743751061.png", "https://image.prepladder.com/notes/HuTBYj8Iaqi4wMXJFg5D1743751084.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AzBzbm5ihVkRihpqVSfF1746952349.mp3", "video": ""}, {"text": "Which of the following statements about aqueous humor are incorrect? Aqueous humor is formed from the non-pigmented epithelium of ciliary processes Aqueous constitutes 99% water The non-pigmented epithelium has a Na/Cl symporter responsible for aqueous humor secretion. The rate of formation of Aqueous humor is 2.3 microlitres/min", "options": [{"label": "A", "text": "1, 2, 4 are incorrect", "correct": false}, {"label": "B", "text": "Only 3 is incorrect", "correct": true}, {"label": "C", "text": "1,3 is incorrect", "correct": false}, {"label": "D", "text": "Only 1 is incorrect", "correct": false}], "correct_answer": "B. Only 3 is incorrect", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/DXhrzohhZfAWEPwFXP3j1743747773.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eEWEEWSbyN8IY3h2EcGQ1746877140.mp3", "video": ""}, {"text": "Which type of tonometer measures intraocular pressure (IOP) by assessing how much a plunger indents the eye?", "options": [{"label": "A", "text": "Schiotz Tonometer", "correct": true}, {"label": "B", "text": "Goldmann Tonometer", "correct": false}, {"label": "C", "text": "Perkins Tonometer", "correct": false}, {"label": "D", "text": "Draeger Tonometer", "correct": false}], "correct_answer": "A. Schiotz Tonometer", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/nIM9fdBZImjHURFggJFT1743749152.png", "https://image.prepladder.com/notes/W46wxVTqSXjwncMikTnO1743749174.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/u2ipyn26n0hEvNWVkdxj1746951352.mp3", "video": ""}, {"text": "A 58-year-old man presents for a routine eye examination. His intraocular pressure (IOP) is consistently measured at 23 mm Hg on multiple occasions. He reports no visual symptoms, and his fundus examination shows no abnormalities. Visual field testing reveals no defects. Based on these findings, which of the following diagnoses is most appropriate?", "options": [{"label": "A", "text": "Normal tension glaucoma", "correct": false}, {"label": "B", "text": "Ocular hypertension", "correct": true}, {"label": "C", "text": "Acute angle-closure glaucoma", "correct": false}, {"label": "D", "text": "Secondary glaucoma", "correct": false}], "correct_answer": "B. Ocular hypertension", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>ASPECT</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>OCULAR HYPERTENSION</strong></p>\n<p style=\"text-align: center;\"><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>NORMAL TENSION GLAUCOMA</strong></p>\n<p style=\"text-align: center;\"><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristic Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>IOP consistently above 21 <span class=\"customMeta\" data-dictid=\"66ae2626ae169277719278edf9936d\">mm Hg</span> (No Damage)</li>\n<li>No <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">Fundus</span> findings</li>\n<li>No <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> defects</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>IOP is normal.</li>\n<li>Fundus changes Present</li>\n<li>Visual field <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> present</li>\n<li>The <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber angle is open on gonioscopy, and there is no <span class=\"customMeta\" data-dictid=\"6f60a6c9ae169277719874336a4e0c\">secondary cause</span> for the changes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Consistent <span class=\"customMeta\" data-dictid=\"44317409bb16927771907e9af17a8b\">IOP</span> &gt;30 mm Hg.</li>\n<li>Central corneal <span class=\"customMeta\" data-dictid=\"facd67f6341692777200653d383689\">thickness</span> &lt;550 µm.</li>\n<li>Vertical cup-to-disc ratio &gt;0.7.</li>\n<li>Increased age.</li>\n<li>Increased pattern standard <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> (PSD) on Humphrey <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> test.</li>\n<li>Disc hemorrhages (splinter hemorrhages near or over the disc).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Raynaud phenomenon</li>\n<li>Migraine: Increased risk.</li>\n<li>Nocturnal <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> hypotension: Low <span class=\"customMeta\" data-dictid=\"263ee5444e1692777183a7e8e704da\">blood pressure</span> during the night, or overtreated <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> hypertension.</li>\n<li>Reduced <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> <span class=\"customMeta\" data-dictid=\"12c4510e191692777201c23ec126a3\">velocity</span> in the <span class=\"customMeta\" data-dictid=\"c09776e61f1692777194db295c590f\">ophthalmic</span> artery</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>When these risk factors are present, treatment may be initiated similarly to open-angle glaucoma, but with a less aggressive approach.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Medical Treatment:</strong> Target the <span class=\"customMeta\" data-dictid=\"44317409bb16927771907e9af17a8b\">IOP</span> levels to be around 12-14 mm Hg. <span class=\"customMeta\" data-dictid=\"42815e46071692777196c90c46f78b\">Prostaglandin</span> analogues (e.g., latanoprost) are preferred for their effective <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> <span class=\"customMeta\" data-dictid=\"bf6247405e16927771891b6a068d36\">hypotensive</span> effect. <span class=\"customMeta\" data-dictid=\"806eb8418c16927771822855b56695\">Beta</span> blockers and <span class=\"customMeta\" data-dictid=\"0132a02ec31692777180a840765aff\">adrenergic</span> drugs should be avoided due to potential adverse effects on <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve perfusion.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/05XtKxRwOMTUGVt90bQs1746951184.mp3", "video": ""}, {"text": "A 65-year-old woman with a history of glaucoma reports worsening vision, headaches, and difficulty with reading. Her IOP shows significant fluctuations throughout the day, and fundus examination reveals optic disc cupping with visual field defects. Which of the following about IOP changes in POAG is false?", "options": [{"label": "A", "text": "Diurnal variation includes a morning rise in IOP in 20% of cases and a biphasic rise in 55% of cases.", "correct": false}, {"label": "B", "text": "In early POAG, IOP is consistently above 21 mm Hg.", "correct": true}, {"label": "C", "text": "IOP is higher in winter due to seasonal variations.", "correct": false}, {"label": "D", "text": "Strenuous exercise temporarily lowers IOP.", "correct": false}], "correct_answer": "B. In early POAG, IOP is consistently above 21 mm Hg.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MpHmbP8n5dXlGF3MvKpQ1746951717.mp3", "video": ""}, {"text": "Which gene mutation is linked to the development of primary open angle glaucoma?", "options": [{"label": "A", "text": "MYOC gene", "correct": true}, {"label": "B", "text": "LOXL1 gene", "correct": false}, {"label": "C", "text": "PAX6 gene", "correct": false}, {"label": "D", "text": "RB1 gene", "correct": false}], "correct_answer": "A. MYOC gene", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JTMR7pp1jafX4IztHdUF1746878923.mp3", "video": ""}, {"text": "Which of the following is not a recognized risk factor for Primary Open-Angle Glaucoma?", "options": [{"label": "A", "text": "Elevated intraocular pressure", "correct": false}, {"label": "B", "text": "Diastolic perfusion pressure of more than 55 mm Hg", "correct": true}, {"label": "C", "text": "Family history of glaucoma", "correct": false}, {"label": "D", "text": "High myopia", "correct": false}], "correct_answer": "B. Diastolic perfusion pressure of more than 55 mm Hg", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UWeNKTFO5NomY3Cx7IDI1746878690.mp3", "video": ""}, {"text": "All the following statements about trabecular meshwork are true except;", "options": [{"label": "A", "text": "It regulates the production of aqueous humor", "correct": true}, {"label": "B", "text": "Trabecular meshwork secrete Glycosaminoglycans", "correct": false}, {"label": "C", "text": "It facilitates the drainage of aqueous humor from the anterior chamber of the eye", "correct": false}, {"label": "D", "text": "Trabecular meshwork has 3 parts and among the three, juxtacanalicular has the maximum resistance", "correct": false}], "correct_answer": "A. It regulates the production of aqueous humor", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/0mgoZJ9gjJLNwuhaOx5c1743748180.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/v6411F26naPSm6vLIgpy1746878239.mp3", "video": ""}, {"text": "Which of the following best describes the role of uveoscleral outflow in intraocular pressure regulation?", "options": [{"label": "A", "text": "It involves the drainage of aqueous humor through the trabecular meshwork and Schlemm's canal.", "correct": false}, {"label": "B", "text": "It accounts for the drainage of aqueous humor through the ciliary body and sclera, providing an alternative pathway to the conventional outflow route.", "correct": true}, {"label": "C", "text": "It is the process by which aqueous humor exits the eye through the vitreous body.", "correct": false}, {"label": "D", "text": "It describes the absorption of aqueous humor by the corneal endothelium.", "correct": false}], "correct_answer": "B. It accounts for the drainage of aqueous humor through the ciliary body and sclera, providing an alternative pathway to the conventional outflow route.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/2AGm4wQ4OMoCnMKn1w3M1743748042.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/oIBMOooyxOfxuUUeYkzD1746956893.mp3", "video": ""}, {"text": "All the following constituents are more in aqueous humor compared to that of plasma except", "options": [{"label": "A", "text": "Lactate", "correct": false}, {"label": "B", "text": "Ascorbate", "correct": false}, {"label": "C", "text": "Pyruvate", "correct": false}, {"label": "D", "text": "Glucose", "correct": true}], "correct_answer": "D. Glucose", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/P0ffaFpZYSRVG1YDTUGk1746877465.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 28 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient complains of eye pain and difficulty seeing after watching a movie. What is the first step in management?", "options": [{"label": "A", "text": "Mannitol with moxifloxacin", "correct": false}, {"label": "B", "text": "Mannitol with pilocarpine", "correct": true}, {"label": "C", "text": "Mannitol with atropine", "correct": false}, {"label": "D", "text": "Mannitol with carboxymethylcellulose", "correct": false}], "correct_answer": "B. Mannitol with pilocarpine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"67ba030b801692777191d63dce44b4\"&gt;Mannitol&lt;/span&gt; with\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the possible diagnosis for the child in the image who displays enlarged corneas, sensitivity to light, and excessive tearing?", "options": [{"label": "A", "text": "Congenital glaucoma", "correct": true}, {"label": "B", "text": "Retinoblastoma", "correct": false}, {"label": "C", "text": "Congenital hereditary endothelial dystrophy", "correct": false}, {"label": "D", "text": "Megalocornea", "correct": false}], "correct_answer": "A. Congenital glaucoma", "question_images": ["https://image.prepladder.com/content/E50Px7WwzBWwCD9kpJ0Z1695197916.png"], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a 50-year-old woman who is experiencing sudden eye pain and redness? An image of her eye is provided for reference.", "options": [{"label": "A", "text": "Acute retrobulbar neuritis", "correct": false}, {"label": "B", "text": "Acute angle-closure glaucoma", "correct": true}, {"label": "C", "text": "Acute anterior uveitis", "correct": false}, {"label": "D", "text": "Severe keratoconjunctivitis", "correct": false}], "correct_answer": "B. Acute angle-closure glaucoma", "question_images": ["https://image.prepladder.com/notes/3qBMtgCHsks5EwHDT1of1747985683.png"], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\"&gt;Acute&lt;/span&gt; angle-closure glau\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The drug increasing uveoscleral flow is?", "options": [{"label": "A", "text": "Timolol", "correct": false}, {"label": "B", "text": "Latanoprost", "correct": true}, {"label": "C", "text": "Pilocarpine", "correct": false}, {"label": "D", "text": "Carbonic anhydrase inhibitor", "correct": false}], "correct_answer": "B. Latanoprost", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "True regarding POAG: Abnormality of trabecular meshwork is seen on gonioscopy First degree relatives have more chances of developing steroid induced glaucoma Dilatation of pupil is associated with exacerbation of IOP First degree relatives are at 1% increased risk of POAG Visual field defect can exist with normal C:D ratio", "options": [{"label": "A", "text": "1,2,4 and 5", "correct": false}, {"label": "B", "text": "1,2 and 3", "correct": false}, {"label": "C", "text": "2 and 5 only", "correct": true}, {"label": "D", "text": "2,3 and 4", "correct": false}], "correct_answer": "C. 2 and 5 only", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a patient with primary open-angle glaucoma, which of the following pupillary abnormalities is most commonly seen?", "options": [{"label": "A", "text": "Marcus Gunn pupil", "correct": true}, {"label": "B", "text": "Adie’s tonic pupil", "correct": false}, {"label": "C", "text": "Argyll-Robertson pupil", "correct": false}, {"label": "D", "text": "Hutchinson’s pupil", "correct": false}], "correct_answer": "A. Marcus Gunn pupil", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/WPmYNeW7344nJ1YAnQKp1745841845.png"], "explanation": "<p>Correct Answer A - &lt;span class=\"customMeta\" data-dictid=\"f35d1c845c16927771911331683127\"&gt;Marcus Gunn&lt;/span&gt; pupil</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Optic neuritis</li>\n<li>Optic neuropathy</li>\n<li>Chiasmal compression</li>\n<li>Intraocular hemorrhage</li>\n<li>Central <span class=\"customMeta\" data-dictid=\"3963a2e0fa169277719874304f5705\">serous</span> retinopathy</li>\n<li>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</li>\n<li>Retinal detachment</li>\n</ul>\n</td>\n<td rowspan=\"7\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Optic <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> lesion</li>\n<li>Central or branch arterial occlusion</li>\n<li>Central or branch <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> occlusion</li>\n<li>Anisometropic amblyopia</li>\n<li>Cataract</li>\n<li>Corneal scar</li>\n<li>Visual <span class=\"customMeta\" data-dictid=\"3aa5abc2fa169277719488e088076d\">pathway</span> damage</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis for a 2-month-old infant who was brought in by their mother due to complaints of light sensitivity, difficulty opening the eyes, and excessive tearing?", "options": [{"label": "A", "text": "Ophthalmia neonatorum", "correct": false}, {"label": "B", "text": "Congenital glaucoma", "correct": true}, {"label": "C", "text": "Congenital Dacryocele", "correct": false}, {"label": "D", "text": "Congenital Cataract", "correct": false}], "correct_answer": "B. Congenital glaucoma", "question_images": ["https://image.prepladder.com/content/6vwA1TNjbJg1y1OxA71F1745409183.png"], "explanation_images": ["https://image.prepladder.com/notes/zyNteOFstZweQoV8tEgZ1746440883.png", "https://image.prepladder.com/notes/jp7ogj2EYD6MoN5dMLpE1746440929.png"], "explanation": "<p>Correct Answer B - &lt;span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\"&gt;Congenital&lt;/span&gt; glaucoma:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ol>\n<li><strong>Newborn glaucoma/ True <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> glaucoma:</strong> Elevated <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure is present during <span class=\"customMeta\" data-dictid=\"1d5d2712dc169277719050154d38a1\">intrauterine</span> life, resulting in <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> at birth. Typically presents within the first month of life.</li>\n<li><strong>Infantile:</strong> ≤ 3 yrs of age</li>\n<li><strong>Juvenile:</strong> &gt; 3 yrs of age</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Trabeculodysgenesis</li>\n<li>Angle Recess Absence</li>\n<li>Iris Insertion Types:\n\t\t\t\t<ul>\n<li>Flat Insertion: Reveals the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body and scleral spur.</li>\n<li>Concave Insertion: Obscures the <span class=\"customMeta\" data-dictid=\"d523549f091692777198f5ec70ed9e\">scleral spur</span> and <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Classic Triad:</strong> Lacrimation, photophobia, and blepharospasm; often accompanied by eye rubbing.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Congenital Glaucoma\" data-author=\"S. Senthil, S. Badakere, Jonnadula Ganesh, Rashmi Krishnamurthy, Siddharth Dikshit, N. Choudhari, C. Garudadri, A. Mandal\" data-hash=\"11918\" data-license=\"Open access\" data-source=\"https://www.semanticscholar.org/paper/Profile-of-childhood-glaucoma-at-a-tertiary-center-Senthil-Badakere/bc27a485cc916e6c96e909f8d28a97ba8737b151\" data-tags=\"May2025\" height=\"217\" src=\"https://image.prepladder.com/notes/zyNteOFstZweQoV8tEgZ1746440883.png\" width=\"556\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Corneal Signs:</strong>\n<ul>\n<li>Oedema: Early sign, may progress to permanent opacity.</li>\n<li>Enlargement: Corneal <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> &gt;13 mm confirms enlargement; &gt;16 mm indicates poor prognosis.</li>\n</ul>\n</li>\n<li><strong>Haab’s Striae:</strong> Tears in Descemet's membrane, visible as <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> lines.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Haab's Striae\" data-author=\"Maxwell, Giorgina &amp; Souzeau, Emmanuelle.\" data-hash=\"11920\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Ocular-signs-of-childhood-glaucoma-A-Megalocornea-and-corectopia-B-Haab-striae_fig2_383522893\" data-tags=\"May2025\" height=\"281\" src=\"https://image.prepladder.com/notes/jp7ogj2EYD6MoN5dMLpE1746440929.png\" width=\"332\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Additional Features:\n\t\t\t\t<ul>\n<li><strong>Deep Anterior Chamber:</strong> Indicates elevated IOP.</li>\n<li>Optic Disc Changes: Variable <span class=\"customMeta\" data-dictid=\"4d57ccd00f1692777185c371df0426\">cupping</span> and atrophy.</li>\n<li><strong>Raised IOP:</strong> Elevated but not acute.</li>\n<li><strong>Axial Myopia:</strong> Due to increased <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Direct Goniotomy followed by Trabeculotomy</strong> - preferred management for <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> Glaucoma</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which medication should be avoided in a 30-year-old female presenting with redness, pain, increased intraocular pressure, keratic precipitates, and aqueous flare?", "options": [{"label": "A", "text": "Beta-blockers", "correct": false}, {"label": "B", "text": "Mannitol", "correct": false}, {"label": "C", "text": "Carbonic anhydrase inhibitors", "correct": false}, {"label": "D", "text": "Prostaglandin analogues", "correct": true}], "correct_answer": "D. Prostaglandin analogues", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Prostaglandin Analogues: </strong></p>\n<p>Latanoprost, Bimatoprost, Travoprost, Tafluprost</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Mechanism:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Increases uveoscleral outflow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sandy eyes, <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> fat atrophy, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis, <span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\">cystoid</span> <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, <span class=\"customMeta\" data-dictid=\"8e2fbd6bcf16927771883ebfccaa77\">heterochromia</span> iridis, hypertrichosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindications:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, diabetes mellitus, <strong>Anterior <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">Uveitis</span> (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Beta Blockers: (Option A)</strong></p>\n<ul>\n<li><strong>Non-Selective:</strong> Timolol, Levobunolol, Carteolol, Metipranolol</li>\n<li><strong>Selective:</strong> Betaxolol, Levobetaxolol</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> secretion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Allergic blepharoconjunctivitis, dry eyes, corneal hypoesthesia</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Alpha-2 Agonists:</strong></p>\n<p>Brimonidine (long-term use), Apraclonidine (IOP spikes)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reduces <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> production, increases uveoscleral outflow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lid retraction, <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> depression (Brimonidine), allergic blepharoconjunctivitis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Contraindications:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Children &lt;2 years</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Additional:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Brimonidine: Safest during pregnancy (Category B)</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Miotics:</strong></p>\n<p>Pilocarpine, Physostigmine, Echothiophate</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stimulates M3 receptors, increasing trabecular outflow</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Brow pain, miosis, <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (Echothiophate), <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> tears</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">Anhydrase</span> Inhibitors: (Option C)</strong></p>\n<p>Acetazolamide (systemic), Brinzolamide, Dorzolamide (topical)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> secretion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ciliary edema, secondary angle-closure glaucoma</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Osmotic agents: (Option B)</strong></p>\n<p>Mannitol (IV), <span class=\"customMeta\" data-dictid=\"124462cc291692777188e1a9cce583\">Glycerol</span> (oral)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lowers <span class=\"customMeta\" data-dictid=\"44317409bb16927771907e9af17a8b\">IOP</span> by creating an osmotic gradient</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adverse effects:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Cardiac overload, <span class=\"customMeta\" data-dictid=\"0b72f5e96b16927772018dec8a87e2\">urinary</span> retention</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following medications should not be administered to a patient with a known case of angle closure glaucoma who has also been diagnosed with major depressive disorder?", "options": [{"label": "A", "text": "Amitriptyline", "correct": true}, {"label": "B", "text": "Sertraline", "correct": false}, {"label": "C", "text": "Mirtazapine", "correct": false}, {"label": "D", "text": "Fluvoxamine", "correct": false}], "correct_answer": "A. Amitriptyline", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-Muscarinic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ipratropium bromide, Thiotropium <span class=\"customMeta\" data-dictid=\"749f9a02041692777183f4f13efcc5\">bromide</span> (M1)</li>\n<li>Toletrodine, Oxybutinin (M3)</li>\n<li>Scopolamine (M1)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-Histaminics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diphenhydramine, Fexofenadine (H1)</li>\n<li>Cimetidine, <span class=\"customMeta\" data-dictid=\"1fc26205e01692777197633c471983\">Ranitidine</span> (H2)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Migraine drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sumatriptan</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-depressants</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>SNRI: Duloxetine and Milnacipram</li>\n<li>TCA: Amitryptiline</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anti-Epileptics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Topiramate, Zonisamide</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Antibiotics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Trimethoprim-Sulfametoxazole (Cotrimoxazole)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following instruments are considered the gold standard for measuring intraocular pressure?", "options": [{"label": "A", "text": "Gonioscope", "correct": false}, {"label": "B", "text": "Goldmann applanation tonometer", "correct": true}, {"label": "C", "text": "Hertel’s exophthalmometer", "correct": false}, {"label": "D", "text": "Tonopen", "correct": false}], "correct_answer": "B. Goldmann applanation tonometer", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/q1S2w36zdW9UxtcIahZT1746103323.png", "https://image.prepladder.com/content/iKBu1DdPigMeXUIbgSdH1747905936.png", "https://image.prepladder.com/content/gT8bVIvvvZ7RL8H81gzM1746103323.png", "https://image.prepladder.com/content/7Q3TQlLtGIlvabz27MPQ1746103323.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a neonate who presents with symptoms of photophobia and excessive tearing, along with a clinical examination showing a normal tear passage and a clear, but abnormally large cornea, and the presence of Haab's striae in the eye image below?", "options": [{"label": "A", "text": "Buphthalmos", "correct": true}, {"label": "B", "text": "Keratoconus", "correct": false}, {"label": "C", "text": "Trachoma", "correct": false}, {"label": "D", "text": "Keratoglobus", "correct": false}], "correct_answer": "A. Buphthalmos", "question_images": ["https://image.prepladder.com/content/3RwoNiAYiyFcJ2DUyRZE1746095439.png"], "explanation_images": ["https://image.prepladder.com/content/r0e9Xb3NXO4nNEhBc4qv1747905513.png", "https://image.prepladder.com/content/TYypjtljdoCf48zJS7a11747905528.png", "https://image.prepladder.com/content/OlPpJLeI5PQpWyK556xN1747905540.png", "https://image.prepladder.com/content/Ib5udK2wwRgGYYNXq1bs1747922202.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li><strong>Newborn glaucoma/ True <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> glaucoma:</strong> Elevated <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure is present during <span class=\"customMeta\" data-dictid=\"1d5d2712dc169277719050154d38a1\">intrauterine</span> life, resulting in <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> at birth. Typically presents within the first month of life.</li>\n<li><strong>Infantile:</strong> ≤ 3 yrs of age</li>\n<li><strong>Juvenile:</strong> &gt; 3 yrs of age</li>\n</ul>\n<p> </p>\n<p>(<strong>Buphthalmos:</strong> meaning \"bull-like eyes,\" is a condition characterized by the <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> of the eyeball. It typically manifests before the age of 3 years and results from the accumulation and <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor.)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Trabeculodysgenesis</li>\n<li>Angle Recess Absence</li>\n<li>Iris Insertion Types\n\t\t\t\t<ul>\n<li>Flat Insertion: Reveals the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body and scleral spur.</li>\n<li>Concave Insertion: Obscures the <span class=\"customMeta\" data-dictid=\"d523549f091692777198f5ec70ed9e\">scleral spur</span> and <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body.</li>\n</ul>\n</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"S. Senthil, S. Badakere, Jonnadula Ganesh, Rashmi Krishnamurthy, Siddharth Dikshit, N. Choudhari, C. Garudadri, A. Mandal\" data-hash=\"\" data-license=\"Open access\" data-source=\"https://www.semanticscholar.org/paper/Profile-of-childhood-glaucoma-at-a-tertiary-center-Senthil-Badakere/bc27a485cc916e6c96e909f8d28a97ba8737b151\" data-tags=\"\" height=\"1627\" src=\"https://image.prepladder.com/content/TYypjtljdoCf48zJS7a11747905528.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Classic Triad:</strong> Lacrimation, photophobia, and blepharospasm; often accompanied by eye rubbing.</li>\n<li><strong>Corneal Signs:</strong>\n<ul>\n<li>Oedema: Early sign, may progress to permanent opacity.</li>\n<li>Enlargement: Corneal <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> &gt;13 mm confirms enlargement; &gt;16 mm indicates poor prognosis.</li>\n</ul>\n</li>\n<li><strong>Haab’s Striae:</strong> Tears in Descemet's membrane, visible as <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> lines.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Maxwell, Giorgina &amp; Souzeau, Emmanuelle.\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Ocular-signs-of-childhood-glaucoma-A-Megalocornea-and-corectopia-B-Haab-striae_fig2_383522893\" data-tags=\"\" height=\"3528\" src=\"https://image.prepladder.com/content/OlPpJLeI5PQpWyK556xN1747905540.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Additional Features:\n\t\t\t\t<ul>\n<li><strong>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> Chamber:</strong> Indicates elevated IOP.</li>\n<li>Optic Disc Changes: Variable <span class=\"customMeta\" data-dictid=\"4d57ccd00f1692777185c371df0426\">cupping</span> and atrophy.</li>\n<li><strong>Raised IOP:</strong> Elevated but not acute.</li>\n<li><strong>Axial Myopia:</strong> Due to increased <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Direct Goniotomy followed by Trabeculotomy</strong> - preferred management for <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> Glaucoma</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "After an acute episode of angle-closure glaucoma, which triad of symptoms is typically observed?", "options": [{"label": "A", "text": "Vogt's triad", "correct": true}, {"label": "B", "text": "Virchow triad", "correct": false}, {"label": "C", "text": "Hutchinson's triad", "correct": false}, {"label": "D", "text": "Gaucher triad", "correct": false}], "correct_answer": "A. Vogt's triad", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/O4CPNJU3S6KFyWqSqG8o1745303080.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which of the following conditions is atropine not recommended for use?", "options": [{"label": "A", "text": "Acute congestive glaucoma", "correct": true}, {"label": "B", "text": "Acute anterior uveitis", "correct": false}, {"label": "C", "text": "Malignant glaucoma", "correct": false}, {"label": "D", "text": "Corneal ulcer", "correct": false}], "correct_answer": "A. Acute congestive glaucoma", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for an infant brought in with symptoms of excessive tear production, sensitivity to light, and blepharospasm?", "options": [{"label": "A", "text": "Congenital glaucoma", "correct": true}, {"label": "B", "text": "Congenital cataract", "correct": false}, {"label": "C", "text": "Congenital Dacryocystitis", "correct": false}, {"label": "D", "text": "Ophthalmia neonatorum", "correct": false}], "correct_answer": "A. Congenital glaucoma", "question_images": ["https://image.prepladder.com/notes/gByemb1KQMLAVnylMosP1745909938.png"], "explanation_images": ["https://image.prepladder.com/content/NpX79qa0eb1WBT6WU8eV1745318455.png", "https://image.prepladder.com/content/TFDv5L2PYbzkwR9DABw31745318460.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Primary <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> Glaucoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"04df903fe8169277719383126b1b02\">Newborn</span> glaucoma/ True <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> glaucoma</strong>: Elevated <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure is present during <span class=\"customMeta\" data-dictid=\"1d5d2712dc169277719050154d38a1\">intrauterine</span> life, resulting in <strong>ocular <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> at birth</strong>. (40% cases)</p>\n<p>Typically presents within the first month of life.</p>\n<p>Often associated with developmental anomalies of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> segment, such as primary <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> glaucoma, which can result from genetic mutations or other <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> conditions.</p>\n<p><strong>2. Infantile: ≤ 3 yrs of age</strong>-<strong> </strong>Infantile <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> is labelled when the disease manifests prior to the child's third birthday</p>\n<p>Affects infants older than 1 month and children up to 3 years.</p>\n<p>Can also result from genetic factors or be secondary to other conditions like Sturge-Weber syndrome or other <span class=\"customMeta\" data-dictid=\"87356352bc169277719923fcc93329\">syndromic</span> associations.</p>\n<p><strong>3. Juvenile: &gt; 3 yrs of age</strong> who develop pressure rise after 3 years but before adulthood. Also known as Juvenile primary open angle glaucoma(POAG) usually occurs between 10 to 35 years of age.</p>\n<p><strong>Buphthalmos</strong>, meaning \"bull-like eyes,\" is a condition characterized by the <span class=\"customMeta\" data-dictid=\"41e56d9a54169277718724ff8c225f\">enlargement</span> of the eyeball. It typically manifests before the age of 3 years and results from the accumulation and <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Trabeculodysgenesis:</strong> Maldevelopment of the trabeculum and iridotrabecular <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> from <span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\">neural</span> <span class=\"customMeta\" data-dictid=\"48528974ed1692777185cd29753db5\">crest</span> cells impairs <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> outflow, causing elevated IOP.</li>\n<li><strong>Angle <span class=\"customMeta\" data-dictid=\"e50e29a57b16927771978b2f6cff3e\">Recess</span> Absence:</strong> The angle <span class=\"customMeta\" data-dictid=\"e50e29a57b16927771978b2f6cff3e\">recess</span> is absent, with the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> inserting either flatly or concavely into the trabeculum.</li>\n<li><strong>Iris Insertion Types:</strong>\n<ul>\n<li><strong>Flat Insertion:</strong> Reveals the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body and scleral spur.</li>\n<li><strong>Concave Insertion:</strong> Obscures the <span class=\"customMeta\" data-dictid=\"d523549f091692777198f5ec70ed9e\">scleral spur</span> and <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Classic Triad:</strong> Lacrimation, photophobia, and blepharospasm; often accompanied by eye rubbing.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"S. Senthil, S. Badakere, Jonnadula Ganesh, Rashmi Krishnamurthy, Siddharth Dikshit, N. Choudhari, C. Garudadri, A. Mandal\" data-hash=\"\" data-license=\"Open access\" data-source=\"https://www.semanticscholar.org/paper/Profile-of-childhood-glaucoma-at-a-tertiary-center-Senthil-Badakere/bc27a485cc916e6c96e909f8d28a97ba8737b151\" data-tags=\"\" height=\"155\" src=\"https://image.prepladder.com/content/NpX79qa0eb1WBT6WU8eV1745318455.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p><strong>Corneal Signs:</strong></p>\n<ul>\n<li><strong>Oedema:</strong> Early sign, may progress to permanent opacity.</li>\n<li><strong>Enlargement:</strong> Corneal <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> &gt;13 mm confirms enlargement; &gt;16 mm indicates poor prognosis.</li>\n</ul>\n<p><strong>Haab’s Striae:</strong> Tears in Descemet's membrane, visible as <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> lines.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Maxwell, Giorgina &amp; Souzeau, Emmanuelle.\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Ocular-signs-of-childhood-glaucoma-A-Megalocornea-and-corectopia-B-Haab-striae_fig2_383522893\" data-tags=\"\" height=\"339\" src=\"https://image.prepladder.com/content/TFDv5L2PYbzkwR9DABw31745318460.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p><strong>Additional Features:</strong></p>\n<ul>\n<li><strong>Thin Sclera:</strong> Appears blue due to underlying uveal tissue.</li>\n<li><strong>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> Chamber:</strong> Indicates elevated IOP.</li>\n<li><strong>Iris Changes:</strong> Iridodonesis and atrophic patches in late stages.</li>\n<li><strong>Lens Changes:</strong> Becomes flat and may subluxate.</li>\n<li><strong>Optic Disc Changes:</strong> Variable <span class=\"customMeta\" data-dictid=\"4d57ccd00f1692777185c371df0426\">cupping</span> and atrophy.</li>\n<li><strong>Raised IOP:</strong> Elevated but not acute.</li>\n<li><strong>Axial Myopia:</strong> Due to increased <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with sudden painful decrease in vision and a fixed, vertically oval pupil. What is the likely diagnosis?", "options": [{"label": "A", "text": "Macular degeneration", "correct": false}, {"label": "B", "text": "Optic neuritis", "correct": false}, {"label": "C", "text": "Acute congestive glaucoma", "correct": true}, {"label": "D", "text": "Acute anterior uveitis", "correct": false}], "correct_answer": "C. Acute congestive glaucoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/FyS1sE5rVge70jkqaluq1747218462.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with a vision problem in the right eye. On examination, the intraocular pressure (IOP) of the Right eye is 50 mmHg, while the IOP of the Left eye is 16 mmHg. Slit lamp examination of the right eye reveals flare cells in the anterior chamber and a cataractous lens. What is the diagnosis?", "options": [{"label": "A", "text": "Phacolytic glaucoma", "correct": true}, {"label": "B", "text": "Malignant glaucoma", "correct": false}, {"label": "C", "text": "Fuch heterochromic iridocyclitis", "correct": false}, {"label": "D", "text": "Phacomorphic glaucoma", "correct": false}], "correct_answer": "A. Phacolytic glaucoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"e049b14c681692777195600b92e00e\"&gt;Phacolytic&lt;/span&gt; glau\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the gold standard method for measuring intraocular pressure in patients?", "options": [{"label": "A", "text": "Hertel’s exophthalmometer", "correct": false}, {"label": "B", "text": "Gonioscope", "correct": false}, {"label": "C", "text": "Goldmann applanation tonometer", "correct": true}, {"label": "D", "text": "Tonopen", "correct": false}], "correct_answer": "C. Goldmann applanation tonometer", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/CnRap3rCY5mCB80ise7g1747312167.png", "https://image.prepladder.com/content/LunKtUuuUuAti9WUXG7Q1747312167.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The first line of treatment for glaucoma in adults is?", "options": [{"label": "A", "text": "PG analogues", "correct": true}, {"label": "B", "text": "Atropine", "correct": false}, {"label": "C", "text": "Acetazolamide", "correct": false}, {"label": "D", "text": "Pilocarpine", "correct": false}], "correct_answer": "A. PG analogues", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with a vision problem in the right eye. On examination, the intraocular pressure (IOP) of the right eye is 50 mmHg, while the IOP of the left eye is 16 mmHg. Slit-lamp examination of the right eye reveals flare cells in the anterior chamber and a cataractous lens. What is the diagnosis?", "options": [{"label": "A", "text": "Phacolytic glaucoma B) Malignant glaucoma C) Fuch's heterochromic iridocyclitis D) Phacomorphic glaucoma", "correct": true}, {"label": "B", "text": "Malignant glaucoma", "correct": false}, {"label": "C", "text": "Fuch's heterochromic iridocyclitis", "correct": false}, {"label": "D", "text": "Phacomorphic glaucoma", "correct": false}], "correct_answer": "A. Phacolytic glaucoma B) Malignant glaucoma C) Fuch's heterochromic iridocyclitis D) Phacomorphic glaucoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/nBeyBfOIodT2j8FfXg4w1741274719.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phacomorphic <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">Glaucoma</span> </strong><strong>(Option D) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phacolytic <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">Glaucoma</span> </strong><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Intumescent <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> blocks the pupil.</li>\n<li>this pushes the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> forward,</li>\n<li>blocking the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber angle,</li>\n<li>leading to angle-closure glaucoma.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Leakage of lens proteins from a <span class=\"customMeta\" data-dictid=\"f534876b5b16927771891037555d81\">hypermature</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> clogs the trabecular meshwork. <img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"374\" src=\"https://image.prepladder.com/content/nBeyBfOIodT2j8FfXg4w1741274719.png\" width=\"455\"/></li>\n</ul>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Intumescent <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> (mature cataract)</strong></li>\n<li>Anterior <span class=\"customMeta\" data-dictid=\"e53b153fb316927771996481a3e88f\">subluxation</span> of lens</li>\n<li>Spherophakia</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Hypermature (Morgagnian) <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> </strong></li>\n<li>Obstruction of the trabecular <span class=\"customMeta\" data-dictid=\"21a7bbd1e416927771923570b66aad\">meshwork</span> by lens proteins.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Symptoms are similar to <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> primary angle-closure glaucoma.</li>\n<li><strong>Shallow <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</strong></li>\n<li>Ciliary congestion, dilated pupil, and swollen <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> is visible.</li>\n<li><strong>Closed <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber angle</strong> on gonioscopy.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Features of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"ba721aa6a6169277718506de6a226c\">congestive glaucoma</span> due to high IOP.</li>\n<li><strong>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</strong></li>\n<li><strong>Open <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber angle</strong> on gonioscopy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Medical Treatment</strong>: IV mannitol, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> acetazolamide, <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> beta-blockers.</li>\n<li><strong>Laser Iridotomy:</strong> To relieve angle closure.</li>\n<li><strong>Surgical Treatment: </strong>Cataract <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">extraction</span> with PCIOL implantation.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Medical Therapy:</strong> To lower IOP.</li>\n<li><strong>Surgical Treatment:</strong> <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">Extraction</span> of the <span class=\"customMeta\" data-dictid=\"f534876b5b16927771891037555d81\">hypermature</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> and PCIOL implantation.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please arrange the following ocular medications according to their respective side effects. Column A Column B 1. Amiodarone 2. Digoxin 3. Systemic steroids 4. Hydroxychloroquine A. Retinopathy B. Cataract C. Yellow vision D. Optic neuropathy", "options": [{"label": "A", "text": "1-C, 2-D, 3-B, 4-A", "correct": false}, {"label": "B", "text": "1-A, 2-C, 3-B, 4-D", "correct": false}, {"label": "C", "text": "1-D, 2-C, 3-B, 4-A", "correct": true}, {"label": "D", "text": "1-B, 2-A, 3-D, 4-C", "correct": false}], "correct_answer": "C. 1-D, 2-C, 3-B, 4-A", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - 1-D, 2-C, 3-B, 4-A\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding lens induced glaucoma is not incorrect?", "options": [{"label": "A", "text": "Phacomorphic glaucoma is an open angle glaucoma", "correct": false}, {"label": "B", "text": "In phacolytic glaucoma lens capsule is intact.", "correct": false}, {"label": "C", "text": "PPhacomorphic glaucoma has a shallow anterior chamber", "correct": true}, {"label": "D", "text": "Mature cataract is an example of phacolytic glaucoma", "correct": false}], "correct_answer": "C. PPhacomorphic glaucoma has a shallow anterior chamber", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Phacomorphic &lt;span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\"&gt;glaucoma&lt;/span&gt; has a shallow &lt;span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\"&gt;anterior&lt;/span&gt; ch\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the name of the device as shown in the image, used for the management of the glaucoma ?", "options": [{"label": "A", "text": "Ex-Press TM implant", "correct": true}, {"label": "B", "text": "Ahmed glaucoma valve", "correct": false}, {"label": "C", "text": "Molteno implant", "correct": false}, {"label": "D", "text": "Baerveldt implant", "correct": false}], "correct_answer": "A. Ex-Press TM implant", "question_images": ["https://image.prepladder.com/content/JDla4a3WiUDgGqgghpUG1695190401.png"], "explanation_images": ["https://image.prepladder.com/content/DEwAoUtIIgCtyzzYFjJd1715058070.png", "https://image.prepladder.com/content/ysNMxRamN5btTAKM9B201715057001.png"], "explanation": "<p>Correct Option A - Ex-PressTM\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which of the following conditions is 100-day glaucoma observed?", "options": [{"label": "A", "text": "Central retinal vein occlusion", "correct": true}, {"label": "B", "text": "Eale’s disease", "correct": false}, {"label": "C", "text": "Central retinal artery occlusion", "correct": false}, {"label": "D", "text": "Steroid – induced glaucoma", "correct": false}], "correct_answer": "A. Central retinal vein occlusion", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Central &lt;span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\"&gt;retinal&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\"&gt;vein&lt;/span&gt; occlu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 6-year- old child is admitted for evaluation for recurrent seizures . He has a large port-wine stain on the left side of her face as shown below. The MRI of the head shows leptomeningeal angioma. What is the most ocular manifestation of the underlying condition ?", "options": [{"label": "A", "text": "Uveitis", "correct": false}, {"label": "B", "text": "Retinitis pigmentosa", "correct": false}, {"label": "C", "text": "Keratitis", "correct": false}, {"label": "D", "text": "Glaucoma", "correct": true}], "correct_answer": "D. Glaucoma", "question_images": ["https://image.prepladder.com/content/d0KDOvzpxVt07pkkAdkh1691478830.png"], "explanation_images": [], "explanation": "<p>Correct Option D - Glau\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 34 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Fundus examination reveals normal visual acuity and retinal findings. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Myopia", "correct": false}, {"label": "B", "text": "Hyperopia", "correct": false}, {"label": "C", "text": "Anisometropia", "correct": true}, {"label": "D", "text": "Amblyopia", "correct": false}], "correct_answer": "C. Anisometropia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with right-sided field defects in both eyes, but central vision remains unaffected. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Homonymous Hemianopia with Macular Sparing", "correct": true}, {"label": "B", "text": "Heteronymous Hemianopia with Central Sparing", "correct": false}, {"label": "C", "text": "Optic Chiasm Lesion", "correct": false}, {"label": "D", "text": "Optic Tract Lesion", "correct": false}], "correct_answer": "A. Homonymous Hemianopia with Macular Sparing", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ezkdRPntaZnPng2qGzrl1741022029.png", "https://image.prepladder.com/content/BYHZfQtacQwkn2VXPDdp1741022053.png", "https://image.prepladder.com/content/UF4vrJZmRQkYMPTdGZmT1741022071.png", "https://image.prepladder.com/content/snK6ikphebHvnxAfv8aH1741022091.png", "https://image.prepladder.com/content/T9Z2jm7cfZ7El3O9QB1n1741022123.png", "https://image.prepladder.com/content/LhQAZiJP8btuZrL6RVno1741022283.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"3aa5abc2fa169277719488e088076d\">Pathway</span> Lesions and Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Site of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fibers Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Field Defect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> + <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"763\" src=\"https://image.prepladder.com/content/BYHZfQtacQwkn2VXPDdp1741022053.png\" width=\"184\"/></p>\n\t\t\t \n\n\t\t\t<p><strong>Anopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bilateral <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1574\" src=\"https://image.prepladder.com/content/UF4vrJZmRQkYMPTdGZmT1741022071.png\" width=\"1600\"/></p>\n\t\t\t \n\n\t\t\t<p><strong>Bitemporal Hemianopia</strong></p>\n<p><strong>(Heteronymous Hemianopia)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Optic Tract</strong></li>\n<li><strong>Lateral <span class=\"customMeta\" data-dictid=\"00b4dbe9e4169277718881a95f7864\">Geniculate</span> Body (LGB Lesion)</strong></li>\n<li><strong>Optic Radiation</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1600\" src=\"https://image.prepladder.com/content/snK6ikphebHvnxAfv8aH1741022091.png\" width=\"1600\"/></p>\n<p><strong>Homonymous Hemianopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">Cortex</span> without the involvement of tip</strong></p>\n<p><strong>(Post. Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers except <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> representation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1600\" src=\"https://image.prepladder.com/content/T9Z2jm7cfZ7El3O9QB1n1741022123.png\" width=\"1600\"/></p>\n<p><strong>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> Sparing</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tip of Visual Cortex</strong></p>\n<p><strong>(Middle Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Macular Representation of <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">Ipsilateral</span> <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> and <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1600\" src=\"https://image.prepladder.com/content/LhQAZiJP8btuZrL6RVno1741022283.png\" width=\"1599\"/></p>\n\t\t\t \n\n\t\t\t<p><strong>Macular <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">Homonymous</span> Hemianopia</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What does the picture depict in terms of the investigation?", "options": [{"label": "A", "text": "Fundus fluorescein angiography", "correct": true}, {"label": "B", "text": "Optical coherence tomography", "correct": false}, {"label": "C", "text": "Retinal CT", "correct": false}, {"label": "D", "text": "Retinal MRI", "correct": false}], "correct_answer": "A. Fundus fluorescein angiography", "question_images": ["https://image.prepladder.com/content/CQdgzAkFsDnhNhCOvfbJ1747044780.png"], "explanation_images": ["https://image.prepladder.com/content/tnCQg6wbPO0mbeujqGDP1747044889.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Fluorescence Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Hyperfluorescence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Window <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> (RPE)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Atrophy showing background <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> fluorescence</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Pooling of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> under detached RPE</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Age-related <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"df4f1758e2169277718697ae66f3dd\">degeneration</span> (ARMD)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Pooling of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> under <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> retina</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Central <span class=\"customMeta\" data-dictid=\"3963a2e0fa169277719874304f5705\">serous</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> (<strong>CSR</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Leakage into the <span class=\"customMeta\" data-dictid=\"0d7d7c885216927771935437653141\">neurosensory</span> <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> due to the <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> of the inner blood-retinal barrier</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> (<strong>CME</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Leakage from <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> or <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> neovascularization</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy, <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> <span class=\"customMeta\" data-dictid=\"624c00049d1692777193b1a9d81379\">neovascular</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> in ARMD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Staining (long <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> by tissues)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Drusen, normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Leakage from <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve head</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Papilloedema</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Hypofluorescence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Blockage of background fluorescence</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Retinal hemorrhage, hard exudates, <span class=\"customMeta\" data-dictid=\"85dafbf32f1692777195b9d9f035d8\">pigmented</span> clumps</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Occlusion of retinal/choroidal vasculature</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> , <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> occlusion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Loss of vasculature</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Choroideremia, myopic degeneration</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 13 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Identify the surgical instrument depicted in the provided image.", "options": [{"label": "A", "text": "Mixter Forceps", "correct": true}, {"label": "B", "text": "Rampley Forceps", "correct": false}, {"label": "C", "text": "Kocher Forceps", "correct": false}, {"label": "D", "text": "Adson Forceps", "correct": false}], "correct_answer": "A. Mixter Forceps", "question_images": ["https://image.prepladder.com/content/N9W4rOyljstx82uuspc21745932697.png"], "explanation_images": ["https://image.prepladder.com/content/j7xEz9QJls97VhH6gzY11745212141.png", "https://image.prepladder.com/content/DPUoQttnEj15w3D2XkTr1745212148.png", "https://image.prepladder.com/content/opnbBAYvPAzQMlpAq1Sx1745212155.png", "https://image.prepladder.com/content/vOWEqGTtLdKqbIghqJxj1745932836.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Instrument</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Image </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rampley's <span class=\"customMeta\" data-dictid=\"1f8d123d5a16927771996d6f75145f\">Sponge</span> Holding Forceps</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"410\" src=\"https://image.prepladder.com/content/j7xEz9QJls97VhH6gzY11745212141.png\" width=\"410\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Designed in a scissor-like configuration, featuring ratcheted handles with <strong>serrated looped jaws</strong>.</li>\n<li>Used to handle <span class=\"customMeta\" data-dictid=\"793a8f498b169277718854584fe210\">gauze</span> or sponges.</li>\n<li>Used to hold <span class=\"customMeta\" data-dictid=\"bec5d0b8cb1692777188267d64974a\">gall</span> bladder/cervix/tongue etc., during <span class=\"customMeta\" data-dictid=\"f79470fd4a16927771940b525da4db\">operative</span> procedures.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Kocher’s Forceps</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Josephine Bitat\" data-hash=\"\" data-license=\"CC BY-SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Pince_Kocher_-_mus%C3%A9e_HCL_-_instruments_chirurgicaux.jpg\" data-tags=\"\" height=\"232\" src=\"https://image.prepladder.com/content/DPUoQttnEj15w3D2XkTr1745212148.png\" width=\"410\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Serrations in the <span class=\"customMeta\" data-dictid=\"5ff25303a01692777186731f6a4f5c\">distal</span> blades with an opposing tooth at the tip.</li>\n<li>Holds tissues or pedicles securely, preventing slippage and <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> of vessels or bleeders.</li>\n<li>Types:\n\t\t\t\t<ul>\n<li>Straight/Curved.</li>\n<li>Small/medium/large.</li>\n</ul>\n</li>\n<li>Used in <strong>thyroidectomy, hemorrhoidectomy, mastectomy, polypectomy, and hysterectomy</strong>.</li>\n<li>Used to secure tough or <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> tissues in areas like the palms, soles, and <span class=\"customMeta\" data-dictid=\"038a2a2fd4169277719894dc7db4bb\">scalp</span> to prevent vessel <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> during surgery.</li>\n<li>Holds <span class=\"customMeta\" data-dictid=\"793a8f498b169277718854584fe210\">gauze</span> and <span class=\"customMeta\" data-dictid=\"793a8f498b169277718854584fe210\">gauze</span> pellets.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Toothed Forceps</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"410\" src=\"https://image.prepladder.com/content/opnbBAYvPAzQMlpAq1Sx1745212155.png\" width=\"410\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Used to hold skin and tough structures like <span class=\"customMeta\" data-dictid=\"65483c739e169277720294dce50377\">fascia</span> and aponeurosis.</li>\n<li>Not used for delicate structures like the bowel, vessels, or nerves.</li>\n<li>May have one-in-two or two-in-three teeth.</li>\n<li><strong>Adson’s <span class=\"customMeta\" data-dictid=\"c01b366a9c1692777203ef77069d2c\">Forceps</span> </strong><strong>(Option D)</strong>: Small, fine <span class=\"customMeta\" data-dictid=\"c01b366a9c1692777203ef77069d2c\">forceps</span> for delicate work; can be toothed or non-toothed.</li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"744\" src=\"https://image.prepladder.com/content/vOWEqGTtLdKqbIghqJxj1745932836.png\" width=\"1999\"/></p>\n<p> </p>\n<ul>\n<li><strong>Victor–Bonney’s Forceps</strong>: Heavy-toothed dissecting forceps.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please determine the instrument provided.", "options": [{"label": "A", "text": "Linear stapler", "correct": true}, {"label": "B", "text": "Skin stapler", "correct": false}, {"label": "C", "text": "Circular stapler", "correct": false}, {"label": "D", "text": "Curved stapler", "correct": false}], "correct_answer": "A. Linear stapler", "question_images": ["https://image.prepladder.com/notes/xdAzI44TSejZQig9VzH61747400843.png"], "explanation_images": ["https://image.prepladder.com/notes/e9Hts3IplcbamH3gvf3Q1747382931.png", "https://image.prepladder.com/notes/ys81WcK211qGlSNSDx1Q1747383038.png", "https://image.prepladder.com/notes/NiT9wjanz88th8kiFYwQ1747407757.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following are used to stop oesophagal variceal bleeding?", "options": [{"label": "A", "text": "A, B &amp;amp; C", "correct": true}, {"label": "B", "text": "A and B only", "correct": false}, {"label": "C", "text": "A, Band C", "correct": false}, {"label": "D", "text": "A, B and D", "correct": false}], "correct_answer": "A. A, B &amp; C", "question_images": ["https://image.prepladder.com/notes/P8XI59f8YDLmEHwJoDa41746518124.png"], "explanation_images": ["https://image.prepladder.com/notes/OH0zdarcbW7eghN8WlkP1746518275.png", "https://image.prepladder.com/notes/gpgzVXqTdDtBFimBX5hi1746518302.png", "https://image.prepladder.com/notes/0kO3dRU25atHMnqR4Dc71746518329.png", "https://image.prepladder.com/notes/ZDPs59o2KHn84OjK8h0y1746518359.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 13 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 25-year-old patient presents with redness and discomfort in the eyes. On examination, the physician notes inflammation confined to the conjunctiva attached to the posterior tarsal plate. Which part of the conjunctiva is primarily affected in this patient?", "options": [{"label": "A", "text": "Bulbar conjunctiva", "correct": false}, {"label": "B", "text": "Forniceal conjunctiva", "correct": false}, {"label": "C", "text": "Palpebral conjunctiva", "correct": true}, {"label": "D", "text": "Limbal conjunctiva", "correct": false}], "correct_answer": "C. Palpebral conjunctiva", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zS2MgPBMVCJiMA9EeyTu1743145933.png", "https://image.prepladder.com/notes/1ZgOx56mOe0ioe21r1no1743662074.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/VAjor1mt8iguUaLXadEw1745319177.mp3", "video": ""}, {"text": "Which of the following structures do not contain any ganglion cells?", "options": [{"label": "A", "text": "Macula", "correct": false}, {"label": "B", "text": "Fovea", "correct": false}, {"label": "C", "text": "Foveola", "correct": true}, {"label": "D", "text": "Periphery of the retina", "correct": false}], "correct_answer": "C. Foveola", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Kyuc2linj0jBbZq69q831743661377.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qMVcKaOiNzHZq7NysPBg1745320017.mp3", "video": ""}, {"text": "Which of the following is the anteroposterior diameter of the adult human eyeball?", "options": [{"label": "A", "text": "23 mm", "correct": false}, {"label": "B", "text": "23.5 mm", "correct": false}, {"label": "C", "text": "24 mm", "correct": true}, {"label": "D", "text": "75 mm", "correct": false}], "correct_answer": "C. 24 mm", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/u5oLvV2uDCi6U35nHBbt1743146102.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1lig4313yOWYeBHMKbxp1745320171.mp3", "video": ""}, {"text": "Which structure primarily offers resistance to aqueous humor outflow within the iridocorneal angle?", "options": [{"label": "A", "text": "Iris", "correct": false}, {"label": "B", "text": "Ciliary Body", "correct": false}, {"label": "C", "text": "Descemet's Membrane", "correct": false}, {"label": "D", "text": "Trabecular Meshwork", "correct": true}], "correct_answer": "D. Trabecular Meshwork", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/H1csIvokBzsXAvfjQ5xV1743662159.png", "https://image.prepladder.com/notes/jz2ATNpi7EXkul485Hk51743662190.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RksdOIt2jhRdgSg1oMW71745320965.mp3", "video": ""}, {"text": "Which of the following statements accurately describes the role of retinal ganglion cells in the visual process?", "options": [{"label": "A", "text": "They are the primary photoreceptors responsible for converting light into electrical signals.", "correct": false}, {"label": "B", "text": "They are concentrated in the fovea and are responsible for colour vision and high visual acuity.", "correct": false}, {"label": "C", "text": "Their axons form the optic nerve, which transmits visual information to the brain.", "correct": true}, {"label": "D", "text": "They contain pigments that undergo structural changes when exposed to light, triggering signal transduction.", "correct": false}], "correct_answer": "C. Their axons form the optic nerve, which transmits visual information to the brain.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/RrxhbCwtstZHz5rwQwec1743662249.png", "https://image.prepladder.com/notes/qNGpxEn1UPISBdOwj9Uw1743662293.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gP6GAC37yhDUJzRjJGPU1745321496.mp3", "video": ""}, {"text": "What is the primary use of the instrument shown in the image given below?", "options": [{"label": "A", "text": "To measure intraocular pressure.", "correct": false}, {"label": "B", "text": "To examine the anterior segment of the eye.", "correct": false}, {"label": "C", "text": "To provide a wide-field view of the retina.", "correct": true}, {"label": "D", "text": "To capture high-resolution images of the retina.", "correct": false}], "correct_answer": "C. To provide a wide-field view of the retina.", "question_images": ["https://image.prepladder.com/notes/Fip371m5QDFfrNeyULQB1743662397.png"], "explanation_images": ["https://image.prepladder.com/notes/Wi94cKcJ6PPkS3s9hTda1743662444.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>DIRECT OPHTHALMOSCOPE</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>INDIRECT OPHTHALMOSCOPE</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>15x magnification</li>\n<li>Virtual image, erect</li>\n<li>Field of view: 2 DD</li>\n<li>Monocular</li>\n<li>Undilated pupil</li>\n<li>Stereopsis absent</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>2-3x magnification</li>\n<li>Real image, inverted</li>\n<li>Field of view: 8 DD</li>\n<li>Binocular</li>\n<li>Dilated pupil</li>\n<li>Stereopsis present</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XL0h667ppQCmKfYHL6uv1745321786.mp3", "video": ""}, {"text": "Which of the following arteries is not a branch of the ophthalmic artery?", "options": [{"label": "A", "text": "Supratrochlear Artery", "correct": false}, {"label": "B", "text": "Dorsal Nasal Artery", "correct": false}, {"label": "C", "text": "Transverse Facial Artery", "correct": true}, {"label": "D", "text": "Short Posterior Ciliary Artery", "correct": false}], "correct_answer": "C. Transverse Facial Artery", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/lKL15izFKEpO7lq5pK8F1743662666.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:609px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Ocular Branches</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Orbital Branches</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (supplies inner 6 layers of retina)</li>\n<li>Long <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries</li>\n<li>Short <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries</li>\n<li>Anterior <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries - <span class=\"customMeta\" data-dictid=\"9e2d8a3f5a16927771932c2348ec52\">Muscular</span> branch</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lacrimal <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> - <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> palpebral artery</li>\n<li>Recurrent meningeal artery</li>\n<li>Supraorbital artery</li>\n<li>Medial palpebral artery</li>\n<li>Posterior <span class=\"customMeta\" data-dictid=\"8c73ef522416927771878a2a17e9bc\">ethmoidal</span> artery</li>\n<li>Anterior <span class=\"customMeta\" data-dictid=\"8c73ef522416927771878a2a17e9bc\">ethmoidal</span> artery</li>\n<li>Dorsal <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (terminal branch)</li>\n<li>Supratrochlear <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (terminal branch)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/a7WAE5HRtOzq7YjZjaP41745322223.mp3", "video": ""}, {"text": "A 32-year-old patient presents with an orbital infection characterized by severe pain, swelling, and redness around the eye. Despite treatment, the patient develops a headache, fever, and neurological deficits, leading to a diagnosis of a brain abscess. What is the most likely route of spread of the infection?", "options": [{"label": "A", "text": "Ethmoidal veins to the cavernous sinus", "correct": false}, {"label": "B", "text": "Facial vein to the cavernous sinus", "correct": false}, {"label": "C", "text": "Superior ophthalmic vein to the cavernous sinus", "correct": true}, {"label": "D", "text": "Angular vein to the internal jugular vein", "correct": false}], "correct_answer": "C. Superior ophthalmic vein to the cavernous sinus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/rwu4k5R6hJ9BaL49YvMf1743662770.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mXnC6L2d71hOOJDDRhI61745322550.mp3", "video": ""}, {"text": "A patient presents to the ophthalmology OPD with the following features: Which of the following conditions is most likely responsible for these symptoms?", "options": [{"label": "A", "text": "Abducens nerve palsy", "correct": false}, {"label": "B", "text": "Optic neuritis", "correct": false}, {"label": "C", "text": "Oculomotor nerve palsy", "correct": true}, {"label": "D", "text": "Trochlear nerve palsy", "correct": false}], "correct_answer": "C. Oculomotor nerve palsy", "question_images": ["https://image.prepladder.com/notes/P5oaCdcJj1txPy85TwSN1746442750.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic nerve (CN II)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Purely sensory</li>\n<li>Senses the incoming light and image displayed on retina</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (CN III)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Innervates majority of the <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> muscles</li>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle, <span class=\"customMeta\" data-dictid=\"fd8276624e169277719113f7a44b76\">levator</span> <span class=\"customMeta\" data-dictid=\"4f6407581c1692777194e86eb9904c\">palpebrae</span> superioris muscle, <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle, and the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> muscle.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trochlear nerve (CN IV)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trigeminal Nerve (CN V)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ophthalmic branch of the <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve provides <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the eye</li>\n<li>Afferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Abducens Nerve (CN VI)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Facial Nerve (CN VII)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> of the orbicularis <span class=\"customMeta\" data-dictid=\"7860833ed41692777194b7b9b531f7\">oculi</span> muscle</li>\n<li>Efferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sympathetic Nervous System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves: Innervates the pupillary <span class=\"customMeta\" data-dictid=\"34cb72fd361692777186bfa0354926\">dilator</span> muscles causing mydriasis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parasympathetic nervous system</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Short <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves:<strong> </strong>Innervates the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> pupillae muscles causing miosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AUoNjtWfogcWUjOvz9231748003058.mp3", "video": ""}, {"text": "During an anatomy lecture, a student learns about the innervation of the eye. The pupil dilates in response to low light conditions. Which nerve fibers are primarily responsible for the dilation of the pupil?", "options": [{"label": "A", "text": "Oculomotor nerve fibers", "correct": false}, {"label": "B", "text": "Trigeminal nerve fibers", "correct": false}, {"label": "C", "text": "Sympathetic nerve fibers", "correct": true}, {"label": "D", "text": "Facial nerve fibers", "correct": false}], "correct_answer": "C. Sympathetic nerve fibers", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic nerve (CN II)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Purely sensory</li>\n<li>Senses the incoming light and image displayed on retina</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (CN III)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Innervates majority of the <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> muscles</li>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle, <span class=\"customMeta\" data-dictid=\"fd8276624e169277719113f7a44b76\">levator</span> <span class=\"customMeta\" data-dictid=\"4f6407581c1692777194e86eb9904c\">palpebrae</span> superioris muscle, <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle, and the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> muscle.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trochlear nerve (CN IV)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trigeminal Nerve (CN V)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ophthalmic branch of the <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve provides <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the eye</li>\n<li>Afferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Abducens Nerve (CN VI)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Facial Nerve (CN VII)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> of the orbicularis <span class=\"customMeta\" data-dictid=\"7860833ed41692777194b7b9b531f7\">oculi</span> muscle</li>\n<li>Efferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sympathetic Nervous System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves: Innervates the pupillary <span class=\"customMeta\" data-dictid=\"34cb72fd361692777186bfa0354926\">dilator</span> muscles causing mydriasis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parasympathetic nervous system</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Short <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves:<strong> </strong>Innervates the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> pupillae muscles causing miosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/L9YYzrXkdcU6EnACtxeY1745322961.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "All of the following are functions of the superior oblique muscle except?", "options": [{"label": "A", "text": "Adduction B) Abduction C) Depression D) Intorsion", "correct": true}, {"label": "B", "text": "Abduction", "correct": false}, {"label": "C", "text": "Depression", "correct": false}, {"label": "D", "text": "Intorsion", "correct": false}], "correct_answer": "A. Adduction B) Abduction C) Depression D) Intorsion", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/y14yHmZ60JheEc2Jv7Ac1741276310.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:650px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> (SR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medial <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> (MR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> (IR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> (LR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> (SO) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> (IO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Elevation</li>\n<li>Adduction</li>\n<li>Intorsion</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Depression</li>\n<li>Adduction</li>\n<li>Extorsion</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Depression (Option C)</strong></li>\n<li><strong>Abduction (Option B)</strong></li>\n<li><strong>Intorsion (Option D)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Elevation</li>\n<li>Abduction</li>\n<li>Extorsion</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following are features of oculomotor nerve palsy except?", "options": [{"label": "A", "text": "Exotropia", "correct": false}, {"label": "B", "text": "Dilated pupil", "correct": false}, {"label": "C", "text": "Limited abduction", "correct": true}, {"label": "D", "text": "Ptosis", "correct": false}], "correct_answer": "C. Limited abduction", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/2HeylIaST5uoHQc8ELAh1741276521.png", "https://image.prepladder.com/content/Ag58gHkdI4t5bq5uKUro1741276606.png", "https://image.prepladder.com/content/rxfz1aByic4m2ocjjlyI1741276639.png", "https://image.prepladder.com/content/B21ldffhDQG2cSFyJYTC1741276669.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:642px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> (SR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medial <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> (MR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> (IR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Levator <span class=\"customMeta\" data-dictid=\"4f6407581c1692777194e86eb9904c\">palpebrae</span> superioris (LPS) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> (IO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Elevation</li>\n<li>Adduction</li>\n<li>Intorsion</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adduction <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Depression</li>\n<li>Adduction</li>\n<li>Extorsion</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elevation of superior <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> <strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Elevation</li>\n<li>Abduction</li>\n<li>Extorsion</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:687px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (cranial nerve III)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Motor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Origin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Midbrain (Oculomotor <span class=\"customMeta\" data-dictid=\"2a56f52a921692777199df43853eba\">sulcus</span> on the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> aspect of the cerebral peduncle).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Course </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1999\" src=\"https://image.prepladder.com/content/Ag58gHkdI4t5bq5uKUro1741276606.png\" width=\"1085\"/></p>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1999\" src=\"https://image.prepladder.com/content/rxfz1aByic4m2ocjjlyI1741276639.png\" width=\"1999\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Components </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"ae7e8fa7d31692777194e3d4325f6b\">Oculomotor</span> <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> (somatic component):</strong></p>\n<p>General <span class=\"customMeta\" data-dictid=\"3db910d8571692777198303e3bcb27\">somatic</span> <span class=\"customMeta\" data-dictid=\"8833ce72c71692777187014d5585e7\">efferent</span> (GSE) fibres emerge from this site and supply -</p>\n<ul>\n<li><strong>Superior division</strong>:</li>\n</ul>\n<ul>\n<li>Levator <span class=\"customMeta\" data-dictid=\"4f6407581c1692777194e86eb9904c\">palpebrae</span> superioris</li>\n<li>Superior rectus</li>\n</ul>\n<ul>\n<li><strong>Inferior division</strong>:</li>\n</ul>\n<ul>\n<li>Medial rectus</li>\n<li>Inferior rectus</li>\n<li>Inferior oblique</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>2.Edinger-Westphal <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> (parasympathetic component) </strong><strong>(Option C ruled out)</strong><strong>:</strong></p>\n<p>General visceral <span class=\"customMeta\" data-dictid=\"8833ce72c71692777187014d5585e7\">efferent</span> (GVE) fibres arise from this site and supply:</p>\n<ul>\n<li><strong>Sphincter pupillae- causes <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> constriction</strong></li>\n<li>Ciliaris</li>\n</ul>\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1999\" src=\"https://image.prepladder.com/content/B21ldffhDQG2cSFyJYTC1741276669.png\" width=\"1999\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In Fundus Fluorescein Angiography (FFA), how do microaneurysms appear?", "options": [{"label": "A", "text": "Hypofluorescent dots", "correct": false}, {"label": "B", "text": "Hyperfluorescent dots", "correct": true}, {"label": "C", "text": "Hypofluorescent line", "correct": false}, {"label": "D", "text": "Hyperfluorescent branching-like structure in the vessel", "correct": false}], "correct_answer": "B. Hyperfluorescent dots", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/xEHVfNKCOUK42xTPaeXr1741789872.png"], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:634px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Fluorescence Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hyperfluorescence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Window <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> (RPE)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Atrophy showing background <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> fluorescence</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Pooling of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> under detached RPE</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Age-related <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"df4f1758e2169277718697ae66f3dd\">degeneration</span> (ARMD)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Pooling of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> under <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> retina</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Central <span class=\"customMeta\" data-dictid=\"3963a2e0fa169277719874304f5705\">serous</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> (CSR)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Leakage into the <span class=\"customMeta\" data-dictid=\"0d7d7c885216927771935437653141\">neurosensory</span> <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> due to the <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> of the inner blood-retinal barrier</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> (CME)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Leakage from <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> or <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> neovascularization</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy, <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> <span class=\"customMeta\" data-dictid=\"624c00049d1692777193b1a9d81379\">neovascular</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> in ARMD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Staining (long <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> by tissues)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Drusen, normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Leakage from <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve head</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Papilloedema</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hypofluorescence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Blockage of background fluorescence</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Retinal hemorrhage<strong> </strong>, hard exudates, <span class=\"customMeta\" data-dictid=\"85dafbf32f1692777195b9d9f035d8\">pigmented</span> clumps</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Occlusion of retinal/choroidal vasculature</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> occlusion, <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> occlusion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Loss of vasculature</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Choroideremia, myopic degeneration</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is true about viscoelastic substances?", "options": [{"label": "A", "text": "Cause mechanical injury to corneal endothelium B) Prevents Anterior Chamber from collapsing during crucial steps like capsulorrhexis and IOL placement C) It is inert and can be left behind after surgery D) Silicone oil, perfluoropropane, and sodium hexafluoride are most commonly used substances", "correct": false}, {"label": "B", "text": "Prevents Anterior Chamber from collapsing during crucial steps like capsulorrhexis and IOL placement", "correct": true}, {"label": "C", "text": "It is inert and can be left behind after surgery", "correct": false}, {"label": "D", "text": "Silicone oil, perfluoropropane, and sodium hexafluoride are most commonly used substances", "correct": false}], "correct_answer": "B. Prevents Anterior Chamber from collapsing during crucial steps like capsulorrhexis and IOL placement", "question_images": [], "explanation_images": [], "explanation": "\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause &amp; Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Secondary Glaucoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Retained <span class=\"customMeta\" data-dictid=\"a7048a89561692777194ff643b1899\">OVD</span> blocks trabecular <span class=\"customMeta\" data-dictid=\"21a7bbd1e416927771923570b66aad\">meshwork</span> → <span class=\"customMeta\" data-dictid=\"44317409bb16927771907e9af17a8b\">IOP</span> <span class=\"customMeta\" data-dictid=\"1931730fd41692777199bf164f574c\">spike</span> (6–24 <span class=\"customMeta\" data-dictid=\"136c4bdd441692777189c5b2e976a0\">hrs</span> post-op).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Capsular Block Syndrome (CBS)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trapped <span class=\"customMeta\" data-dictid=\"a7048a89561692777194ff643b1899\">OVD</span> in capsular bag → <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of IOL/nucleus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pseudo-Anterior Uveitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clumping of RBCs/inflammatory cells due to negative charge.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Post-op <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">Uveitis</span> &amp; Hypopyon</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inflammatory response post-OVD instillation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corneal Edema/Decompensation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Endothelial trauma from <span class=\"customMeta\" data-dictid=\"a7048a89561692777194ff643b1899\">OVD</span> residue.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>IOL Crystallization</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>OVD residues on <span class=\"customMeta\" data-dictid=\"ffac6924ab16927771907dbb6fd7dd\">IOL</span> surface → Fern-like deposits.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Calcific Band Keratopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reported with <span class=\"customMeta\" data-dictid=\"c7e7cc37531692777184e69b81c904\">chondroitin sulfate</span> OVDs.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hypersensitivity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Risk with sodium <span class=\"customMeta\" data-dictid=\"7cf5c442881692777189087f0fbda1\">hyaluronate</span> from rooster combs/streptococcal culture.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following combinations of cylindrical lenses can be employed for the treatment of astigmatism in the with-the-rule orientation?", "options": [{"label": "A", "text": "+5.00 DC x 180, -3.00 DC x 90", "correct": false}, {"label": "B", "text": "+7.00 DC x 180, +5.00 DC x 90", "correct": false}, {"label": "C", "text": "-4.00 DC x 180, -5.00 DC x 90", "correct": false}, {"label": "D", "text": "-3.00 DC x 180, +1.00 DC x 90", "correct": true}], "correct_answer": "D. -3.00 DC x 180, +1.00 DC x 90", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/dD74v2ZybkFgYRJD8sv11685074969.png"], "explanation": "<p>Correct Option D\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the subsequent options aids in distinguishing a fixed dilated pupil? Phenylephrine 1% Pilocarpine 0.1% Pilocarpine Cocaine 0.5% Epinephrine", "options": [{"label": "A", "text": "1,2,3,4 and 5", "correct": false}, {"label": "B", "text": "2 and 3", "correct": true}, {"label": "C", "text": "1,4and 5", "correct": false}, {"label": "D", "text": "1,3 and 4", "correct": false}], "correct_answer": "B. 2 and 3", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/YA8kbdwVXLGjmTvJ724e1746532989.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 16 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Valve of Hasner", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/KkIDsMjSUan09jOnjakT1743142385.png", "https://image.prepladder.com/notes/ijG4TrV1N0KvC4NyeFlc1743142337.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XVp6R0V9RVcnnoophHsH1746001760.mp3", "video": ""}, {"text": "Which of the following is a cause of lacrimal pump failure, leading to excessive tearing (epiphora)?", "options": [{"label": "A", "text": "Trauma to the canaliculus", "correct": false}, {"label": "B", "text": "Bell’s palsy", "correct": true}, {"label": "C", "text": "Obstruction of the nasolacrimal duct", "correct": false}, {"label": "D", "text": "Narrowing of the punctum", "correct": false}], "correct_answer": "B. Bell’s palsy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/s2rdGFkN3oZPG63bTWI61743142546.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DGyfpAGGsxsQdS8mHuNG1746002002.mp3", "video": ""}, {"text": "A 65 y/o male presents with persistent tearing in his right eye that has worsened over the past year. The physician orders an imaging study to pinpoint the exact location of the blockage and assess the condition of the lacrimal sac. Which investigation is most appropriate for this purpose?", "options": [{"label": "A", "text": "Dacryocystography", "correct": true}, {"label": "B", "text": "Fluorescein Dye Disappearance Test (FDDT)", "correct": false}, {"label": "C", "text": "Dacryoscintigraphy", "correct": false}, {"label": "D", "text": "Lacrimal Syringing", "correct": false}], "correct_answer": "A. Dacryocystography", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ZLcjgDMBSC2a6tJlLWXo1743142720.png", "https://image.prepladder.com/notes/JmX8Yb5w5cE7L9WEsfjN1743142754.png", "https://image.prepladder.com/notes/vBdfgbwurk9rdG338CdK1743142795.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uKtjrIVtWVzcZgcOjCEv1746002618.mp3", "video": ""}, {"text": "A 50 y/o man undergoes Jones Test 1 for chronic tearing, which shows no dye on the cotton bud placed in the inferior meatus. Following this, Jones Test 2 is performed, and fluorescein dye is detected after lacrimal syringing. What does this result suggest?", "options": [{"label": "A", "text": "Partial obstruction within the lacrimal passages", "correct": true}, {"label": "B", "text": "Complete obstruction of the nasolacrimal duct", "correct": false}, {"label": "C", "text": "Lacrimal pump failure", "correct": false}, {"label": "D", "text": "Primary hypersecretion of tears", "correct": false}], "correct_answer": "A. Partial obstruction within the lacrimal passages", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/1R7SX2N5aBylOhJ6dGW41749131274.png", "https://image.prepladder.com/notes/i0gzJBtSDXfUS8BMTIbF1749131257.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/EXyQLIemKBCDeNIZSWUR1746078913.mp3", "video": ""}, {"text": "A 9-month-old infant is brought to the clinic with ongoing tearing and discharge from the right eye. Despite regular lacrimal sac massage and topical antibiotics, the symptoms persist. What is the next best step in management?", "options": [{"label": "A", "text": "Continue lacrimal sac massage and antibiotics", "correct": false}, {"label": "B", "text": "Probing of the nasolacrimal duct", "correct": true}, {"label": "C", "text": "Dacryocystorhinostomy (DCR)", "correct": false}, {"label": "D", "text": "Balloon catheter dilation", "correct": false}], "correct_answer": "B. Probing of the nasolacrimal duct", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:610px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Blockage of the <span class=\"customMeta\" data-dictid=\"7ae0be0842169277719364f6d75e91\">nasolacrimal</span> duct, usually at the <span class=\"customMeta\" data-dictid=\"416dd1004a169277720177d9a6adc5\">valve</span> of Hasner</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Typical Age</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present from birth or early infancy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>• Chronic tearing (epiphora)</p>\n<p>• Discharge</p>\n<p>• <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">Recurrent</span> conjunctivitis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>First-Line Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>• <strong>Crigler massage</strong> to open the duct</p>\n<p>• Topical antibiotics for infection</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Indications for Probing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>• Persistence beyond <strong>6–10 months</strong></p>\n<p>• Repeated infections or failure of conservative therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Prognosis with Probing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;90% success if performed before 12–15 months</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7kzBHsZPxG1m8wisUEic1746010942.mp3", "video": ""}, {"text": "Which of the following types of Dacryocystorhinostomy (DCR) is considered for treating nasolacrimal duct obstruction, offering the highest success rate?", "options": [{"label": "A", "text": "External Dacryocystorhinostomy (External DCR)", "correct": true}, {"label": "B", "text": "Endonasal Dacryocystorhinostomy (Endonasal DCR)", "correct": false}, {"label": "C", "text": "Endocanalicular Laser Dacryocystorhinostomy (Laser DCR)", "correct": false}, {"label": "D", "text": "Conjunctivodacryocystorhinostomy (CDCR)", "correct": false}], "correct_answer": "A. External Dacryocystorhinostomy (External DCR)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/inufGQ1pLHF8P6hGPVpP1743143242.png", "https://image.prepladder.com/notes/kaE0RS3Ewr1VvxsnxwRJ1743143317.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/86eDFD50VIfXdbHIAC7Q1746014569.mp3", "video": ""}, {"text": "A 2-week-old infant presents with a bluish swelling in the inner corner of the right eye. The parents report excessive tearing and some slimy discharge from the eye. There is no history of trauma or illness. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Congenital Dacryocele", "correct": true}, {"label": "B", "text": "Dacryoadenitis", "correct": false}, {"label": "C", "text": "Dacryops", "correct": false}, {"label": "D", "text": "Chronic Dacryocystitis", "correct": false}], "correct_answer": "A. Congenital Dacryocele", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/W0Mi2FDk042mxWLwmieP1743143446.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fRc6BUGsFvqg86cag2XJ1746026803.mp3", "video": ""}, {"text": "A 55 y/o woman presents with a persistent swelling below the inner corner of her left eye. She also reports a history of watery eyes and recurrent conjunctivitis. On examination, there is fluctuant swelling at the lacrimal sac, and mucoid fluid can be expressed. What is the most likely diagnosis and appropriate management?", "options": [{"label": "A", "text": "Chronic Dacryocystitis; Probing and syringing.", "correct": false}, {"label": "B", "text": "Chronic Dacryocystitis; Dacryocystorhinostomy (DCR).", "correct": true}, {"label": "C", "text": "Acute Dacryocystitis; Systemic antibiotics and abscess drainage.", "correct": false}, {"label": "D", "text": "Acute Dacryocystitis; Dacryocystectomy (DCT).", "correct": false}], "correct_answer": "B. Chronic Dacryocystitis; Dacryocystorhinostomy (DCR).", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:651px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Acute Dacryocystitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Chronic Dacryocystitis</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Aetiology</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"b5a5dcf4021692777187e3c0d2d47d\">exacerbation</span> of chronic dacryocystitis</li>\n<li>Spread from neighbouring infected structures (e.g., sinuses, bones, <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> abscess)</li>\n<li><strong>Causative organisms: </strong>Streptococcus haemolyticus, Pneumococcus, Staphylococcus</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Stasis and mild infection of long duration</li>\n<li>Common in women aged 40-60</li>\n<li><strong>Causes:</strong> <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> factors (narrow bony canal), <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> diseases, foreign bodies, infection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Clinical Features/ Sequelae</strong></p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ol>\n<li><strong>Stage of cellulitis: </strong>Painful <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> at the <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> sac, epiphora, fever, redness, and oedema.</li>\n<li><strong>Lacrimal abscess: </strong>Pus-filled sac, <span class=\"customMeta\" data-dictid=\"1adaaa6ded16927772023e7fe0c856\">fluctuant</span> swelling, may <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> forming an abscess.</li>\n<li><strong>Fistula formation: </strong>Untreated <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> leads to <span class=\"customMeta\" data-dictid=\"f71e485d131692777199151d1076d2\">spontaneous</span> discharge, forming a fistula.</li>\n</ol>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ol>\n<li><strong>Stage of chronic catarrhal dacryocystitis: </strong>Watering eye, mild redness, NLD block</li>\n<li><strong>Lacrimal mucocele: </strong>Swelling below inner canthus, <span class=\"customMeta\" data-dictid=\"14f3af3bf516927771939c1efb8726\">mucoid</span> fluid regurgitation.</li>\n<li><strong>Chronic <span class=\"customMeta\" data-dictid=\"a48a50d87216927771994f1cfe9b7d\">suppurative</span> dacryocystitis: </strong>Purulent <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> (d/t infection), <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> conjunctivitis.</li>\n</ol>\n<ol>\n<li><strong>Chronic fibrotic sac: </strong>Thickened mucosa, persistent epiphora, <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> folds.</li>\n</ol>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Conjunctivitis, corneal ulcer, lid abscess, <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> cellulitis, rarely <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> sinus</p>\n<p>thrombosis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Conjunctivitis, <span class=\"customMeta\" data-dictid=\"410b701d9916927771861ac447b041\">ectropion</span> of lower lid, risk of corneal ulcers.</p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Treatment</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>Cellulitis:</strong> <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">Systemic</span> antibiotics, anti-inflammatory drugs, hot fomentation.</li>\n<li><strong>Lacrimal abscess:</strong> <span class=\"customMeta\" data-dictid=\"dd824a31e71692777186c7f8168998\">Drainage</span> with incision, antibiotics, possible DCT or DCR later.</li>\n<li><strong>External fistula: </strong>Fistulectomy with DCT or DCR after controlling infection.</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li><strong>Conservative: </strong>Probing and syringing (early stages).</li>\n<li><strong>Dacryocystorhinostomy (DCR):</strong> Preferred surgery to re-establish <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> drainage.</li>\n<li><strong>Dacryocystectomy (DCT):</strong> Indicated if DCR is contraindicated or in cases of fibrosis, infection, or old age.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jcf7CZGOT06gmAShIMyf1746027157.mp3", "video": ""}, {"text": "A 60 y/o man presents with watery eyes, redness, swelling at the inner corner of his right eye, and persistent thick yellow discharge. O/E there is pouting of lacrimal puncta and yellow granules from the punctum upon massage. Which organism is most likely responsible, and what is the definitive treatment?", "options": [{"label": "A", "text": "Eikenella corrodens; Oral antibiotics and steroid drops.", "correct": false}, {"label": "B", "text": "Staphylococcus aureus; Topical antibiotics and warm compresses", "correct": false}, {"label": "C", "text": "Actinomyces israelii; Canaliculotomy", "correct": true}, {"label": "D", "text": "Chlamydia trachomatis; Irrigation and syringing of the tear duct.", "correct": false}], "correct_answer": "C. Actinomyces israelii; Canaliculotomy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ehg0tPXqziKugDHVFWZ51743143776.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/sR9uV7jXRpcrtXjmoxkd1745223709.mp3", "video": ""}, {"text": "A 27 yeal old man presents with a painless, slow-growing, firm mass on the upper eyelid that has been gradually increasing in size over the past year. On examination, the lesion is well-circumscribed, mobile, and non-tender, with no signs of ulceration or inflammation. Imaging reveals a well-defined, lobulated mass without bony invasion. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Pleomorphic Adenoma", "correct": true}, {"label": "B", "text": "Lymphoma", "correct": false}, {"label": "C", "text": "Lacrimal Gland Carcinoma", "correct": false}, {"label": "D", "text": "Dacryocystitis", "correct": false}], "correct_answer": "A. Pleomorphic Adenoma", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jURTA9XVVTY5RxWduzBP1746003248.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 3-year-old child presents with epiphora, and probing reveals a soft block at 7 mm. What is the best treatment option for this condition?", "options": [{"label": "A", "text": "Endonasal Dacryocystorhinostomy (DCR)", "correct": false}, {"label": "B", "text": "Conjunctival Dacryocystorhinostomy (DCR)", "correct": true}, {"label": "C", "text": "External Dacryocystorhinostomy (DCR)", "correct": false}, {"label": "D", "text": "Dacryocystectomy", "correct": false}], "correct_answer": "B. Conjunctival Dacryocystorhinostomy (DCR)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ylqEyp78Mczp5esU8UGZ1741088366.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which bones are cut/removed during external Dacryocystorhinostomy?", "options": [{"label": "A", "text": "Zygomatic", "correct": false}, {"label": "B", "text": "Maxillary", "correct": false}, {"label": "C", "text": "Lacrimal", "correct": true}, {"label": "D", "text": "Frontal", "correct": false}], "correct_answer": "C. Lacrimal", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 3-month-old child was brought to the outpatient department (OPD) with symptoms of photophobia and watering of the eyes. Which of the following is not a cause of this condition?", "options": [{"label": "A", "text": "Congenital nasolacrimal duct obstruction", "correct": false}, {"label": "B", "text": "Congenital entropion", "correct": false}, {"label": "C", "text": "Congenital glaucoma", "correct": false}, {"label": "D", "text": "Congenital distichiasis", "correct": true}], "correct_answer": "D. Congenital distichiasis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the marked structure:", "options": [{"label": "A", "text": "Canal of petit", "correct": true}, {"label": "B", "text": "Canal of hannover", "correct": false}, {"label": "C", "text": "Hyaloid canal", "correct": false}, {"label": "D", "text": "Pars plana", "correct": false}], "correct_answer": "A. Canal of petit", "question_images": ["https://image.prepladder.com/notes/BBUsBfDTMWK9oAfIR2WI1746178192.png"], "explanation_images": ["https://image.prepladder.com/notes/fTtDnslHpJyrZOWWUiG01746178295.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the accurate order of staining in patients with dry eyes? i. Fluorescein stain ii. Lissamine green iii. Rose Bengal stain", "options": [{"label": "A", "text": "i, iii, ii", "correct": false}, {"label": "B", "text": "i, ii, iii", "correct": true}, {"label": "C", "text": "ii, i, ii", "correct": false}, {"label": "D", "text": "iii, ii, i", "correct": false}], "correct_answer": "B. i, ii, iii", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/VbvITP1nGoKORFO7baZ71746006685.png", "https://image.prepladder.com/content/KwdbfWvMWkzAYjm9pK8V1746006685.png", "https://image.prepladder.com/content/VSXzw0U1l8SHj0u69OLY1746006685.png", "https://image.prepladder.com/content/dgDY9GTEonasT0dJbduc1746006685.png", "https://image.prepladder.com/content/S09RelTQERbyCdJultx51746006685.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:713px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Investigations of dry eye</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>1, Slit-lamp examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Superficial corneal erosions</li>\n<li>Inadequate tear lake volume</li>\n<li>Early tear film break-up time</li>\n<li>Conjunctival hyperemia</li>\n<li>Conjunctival surface irregularities</li>\n<li>Meibomian <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> dysfunction</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>2. Schirmer’s Test:</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Schirmer’s test is used to diagnose <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> <span class=\"customMeta\" data-dictid=\"9a642d93fd1692777186d5345e0634\">dry eye</span> disease.</li>\n</ul>\n<p><strong>Schirmer's Test 1</strong></p>\n<ul>\n<li>Measures both <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> and <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> tear secretions</li>\n<li>Uses Whatman-4 filter paper, kept in the lower <span class=\"customMeta\" data-dictid=\"a17eac40ea16927772034ca233cb84\">fornix</span> at the <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> of <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> one-third and <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> two-thirds.</li>\n<li>After 5 minutes, wetting of the filter strip from the bent end is measured.</li>\n<li>Normal value: &gt;15 mm</li>\n<li>5-10 mm: Mild to moderate <span class=\"customMeta\" data-dictid=\"8b4e6e36bb169277719032f22681c2\">keratoconjunctivitis</span> sicca (KCS).</li>\n<li>&lt; 5 mm: Severe KCS</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Dominika Wróbel-Dudzińska, Agnieszka Kubik-Komar, Dorota Rykwa, Ewa Kosior-Jarecka, Tomasz Żarnowski &amp; Renata Chałas \" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://link.springer.com/article/10.1007/s00784-020-03741-3#rightslink\" data-tags=\"\" height=\"430\" src=\"https://image.prepladder.com/content/VbvITP1nGoKORFO7baZ71746006685.png\" width=\"440\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p><a href=\"#_msocom_1\">[1]</a></p>\n<p><strong>Schirmer's Test 2</strong></p>\n<ul>\n<li>Measures only <span class=\"customMeta\" data-dictid=\"923af580cf16927771829606bce2a7\">basal</span> <span class=\"customMeta\" data-dictid=\"9b0ae3750916927771986c15d4ff4d\">secretion</span> under anesthesia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>3. <span class=\"customMeta\" data-dictid=\"0d5565e4a1169277719596227ebffd\">Phenol</span> Red Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A modified Schirmer’s test using a cotton thread impregnated with <span class=\"customMeta\" data-dictid=\"0d5565e4a1169277719596227ebffd\">phenol</span> red dye.</li>\n<li>The thread is placed in the lower <span class=\"customMeta\" data-dictid=\"a17eac40ea16927772034ca233cb84\">fornix</span> for 15 seconds.</li>\n<li>Phenol <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> changes from yellow to red depending on the pH of the tears.</li>\n<li>Wet length: &gt;20 mm: Normal.</li>\n<li>&lt;10 mm: Severe dry eye.</li>\n<li>≤19 mm as <span class=\"customMeta\" data-dictid=\"2d896c605a1692777183d769916056\">borderline</span> dry eye.<strong> </strong></li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Sarah Dougherty Wood, Shahzad I Mian\" data-hash=\"\" data-license=\"CC BY NC \" data-source=\"https://www.touchophthalmology.com/anterior-segment/journal-articles/diagnostic-tools-for-dry-eye-disease/\" data-tags=\"\" height=\"408\" src=\"https://image.prepladder.com/content/KwdbfWvMWkzAYjm9pK8V1746006685.png\" width=\"501\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>4. Tear Film Break-Up Time (TBUT)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Tear film stained with sodium <span class=\"customMeta\" data-dictid=\"468accc4d3169277720252132f5b85\">fluorescein</span> 1% is observed under a <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> lamp, and time is noted after the patient blinks.</li>\n<li>The interval between the complete blink and the first appearance of a ‘dark’ dry spot on the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is recorded as TBUT.</li>\n<li>It is an indicator of the <span class=\"customMeta\" data-dictid=\"fc82a39c2a16927771807cea91e4a6\">adequacy</span> of the <span class=\"customMeta\" data-dictid=\"7d30ef9aee16927771936bdac2c1ff\">mucin</span> component of tears.</li>\n<li>Normal: 15-35 seconds</li>\n<li>&lt; 10 seconds indicates unstable tear film.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Louis Tong, Li Lim, Donald Tiang Hwee Tan, Wee Jin Heng, Jimmy Lim, Cordelia Chan, Anshu Arundhati, Anna Tan\" data-hash=\"\" data-license=\"CC BY NC ND 4.0\" data-source=\"https://www.researchgate.net/figure/Four-patterns-of-tear-film-breakup-clinically-observed-Image-from-Yokoi-N-Georgiev-AG_fig1_356147026\" data-tags=\"\" height=\"441\" src=\"https://image.prepladder.com/content/VSXzw0U1l8SHj0u69OLY1746006685.png\" width=\"596\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>5. Rose Bengal or Lissamine Green</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stain devitalized, desiccated corneal and conjunctival <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> red or green.<strong> </strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jesse Vislisel, MD, Stefani Karakas, CRA\" data-hash=\"\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/Rose-Bengal/index.htm#gsc.tab=0\" data-tags=\"\" height=\"291\" src=\"https://image.prepladder.com/content/dgDY9GTEonasT0dJbduc1746006685.png\" width=\"367\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jesse Vislisel\" data-hash=\"\" data-license=\"CC BY-NC-ND 3.0\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/LG-staining/index.htm#gsc.tab=0\" data-tags=\"\" height=\"289\" src=\"https://image.prepladder.com/content/S09RelTQERbyCdJultx51746006685.png\" width=\"378\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>6. Alcian Blue</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stains <span class=\"customMeta\" data-dictid=\"d4226a4b2e169277719459bb9339d6\">particulate</span> matter in the tear film due to mucus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>7. Tear Osmolarity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increased in dry eye</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>8. Tear to Lysozyme ratio</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Between 0.9 and 0.6 indicates dry eye.</p>\n<p> </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old patient presents with chronic dacryocystitis. She complains of recurrent tearing, discharge, and mild swelling in the inner corner of the eye. The clinical findings and history are consistent with chronic dacryocystitis. What should be the treatment of choice for this patient?", "options": [{"label": "A", "text": "Lacrimal sac massage", "correct": false}, {"label": "B", "text": "Dacryocystorhinostomy", "correct": true}, {"label": "C", "text": "Syringing", "correct": false}, {"label": "D", "text": "Probing", "correct": false}], "correct_answer": "B. Dacryocystorhinostomy", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/eBZKA5HBr5dfvd3BxdFs1746429860.png", "https://image.prepladder.com/content/QMPviM4dGt1w1adlyqPK1746429876.png"], "explanation": "<p>Correct Answer B - Dacryocystorhinostomy</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Acute Dacryocystitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p style=\"text-align:center\"><strong>Chronic Dacryocystitis</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"><strong>Aetiology</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"b5a5dcf4021692777187e3c0d2d47d\">exacerbation</span> of chronic dacryocystitis</li>\n<li>Spread from neighbouring infected structures (e.g., sinuses, bones, <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> abscess)</li>\n<li><strong>Causative organisms: </strong>Streptococcus haemolyticus, Pneumococcus, Staphylococcus</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Stasis and mild infection of long duration</li>\n<li>Common in women aged 40-60</li>\n<li><strong>Causes:</strong> <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> factors (narrow bony canal), <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> diseases, foreign bodies, infection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"><strong>Clinical Features/ Sequelae</strong></p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ol>\n<li><strong>Stage of cellulitis: </strong>Painful <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> at the <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> sac, epiphora, fever, redness, and oedema.</li>\n<li><strong>Lacrimal abscess: </strong>Pus-filled sac, <span class=\"customMeta\" data-dictid=\"1adaaa6ded16927772023e7fe0c856\">fluctuant</span> swelling, may <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> forming an abscess.</li>\n<li><strong>Fistula formation: </strong>Untreated <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> leads to <span class=\"customMeta\" data-dictid=\"f71e485d131692777199151d1076d2\">spontaneous</span> discharge, forming a fistula.</li>\n</ol>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ol>\n<li><strong>Stage of chronic catarrhal dacryocystitis: </strong>Watering eye, mild redness, NLD block</li>\n<li><strong>Lacrimal mucocele: </strong>Swelling below inner canthus, <span class=\"customMeta\" data-dictid=\"14f3af3bf516927771939c1efb8726\">mucoid</span> fluid regurgitation.</li>\n<li><strong>Chronic <span class=\"customMeta\" data-dictid=\"a48a50d87216927771994f1cfe9b7d\">suppurative</span> dacryocystitis: </strong>Purulent <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> (d/t infection), <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> conjunctivitis.</li>\n<li><strong>Chronic fibrotic sac: </strong>Thickened mucosa, persistent epiphora, <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> folds.</li>\n</ol>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Chaiti Aranke Waman Chavan\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Acute-dacryocystitis-with-pre-septal-cellulitis-with-fistula_fig1_381056510\" data-tags=\"\" height=\"327\" src=\"https://image.prepladder.com/content/eBZKA5HBr5dfvd3BxdFs1746429860.png\" width=\"403\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Alexis Mathieu 1,*,Stéphanie Baillif 2,3ORCID,Marie-Noelle Delyfer 1,4ORCID,Éric Longueville 1,Valentine Coste-Verdier 1,Jacques Lagier 2,Abdulrhman Alrabiah 2 andArnaud Martel 2,3ORCID\" data-hash=\"\" data-license=\"OPEN ACCESS\" data-source=\"https://www.mdpi.com/2077-0383/13/17/5129\" data-tags=\"\" height=\"358\" src=\"https://image.prepladder.com/content/QMPviM4dGt1w1adlyqPK1746429876.png\" width=\"334\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Conjunctivitis, corneal ulcer, lid abscess, <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> cellulitis, rarely <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Conjunctivitis, <span class=\"customMeta\" data-dictid=\"410b701d9916927771861ac447b041\">ectropion</span> of lower lid, risk of corneal ulcers.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p style=\"text-align:center\"><strong>Treatment</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Cellulitis:</strong> Systemic antibiotics, anti-inflammatory drugs, hot fomentation.</li>\n<li><strong>Lacrimal abscess:</strong> <span class=\"customMeta\" data-dictid=\"dd824a31e71692777186c7f8168998\">Drainage</span> with incision, antibiotics, possible DCT or DCR later.</li>\n<li><strong>External fistula: </strong>Fistulectomy with DCT or DCR after controlling infection.</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Conservative: </strong>Probing and syringing (early stages).</li>\n<li><strong>Dacryocystorhinostomy (DCR):</strong> Preferred surgery to re-establish <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> drainage.</li>\n<li><strong>Dacryocystectomy (DCT):</strong> Indicated if DCR is contraindicated or in cases of fibrosis, infection, or old age.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most appropriate treatment for a 55-year-old woman who is experiencing long-term mucopurulent discharge from her left eye and swelling near the inner corner of the eye?", "options": [{"label": "A", "text": "Dacryocystorhinostomy", "correct": true}, {"label": "B", "text": "Dacryocystectomy", "correct": false}, {"label": "C", "text": "Incision and drainage", "correct": false}, {"label": "D", "text": "Balloon catheter dilation", "correct": false}], "correct_answer": "A. Dacryocystorhinostomy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/PWUz0RG0DUEfxiReyFzx1747910819.png", "https://image.prepladder.com/notes/giGbkRuPDXpE98NTF0jY1747910854.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:651px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Acute Dacryocystitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Chronic Dacryocystitis</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Aetiology</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"b5a5dcf4021692777187e3c0d2d47d\">exacerbation</span> of chronic dacryocystitis</li>\n<li>Spread from neighbouring infected structures (e.g., sinuses, bones, <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> abscess)</li>\n<li><strong>Causative organisms: </strong>Streptococcus haemolyticus, Pneumococcus, Staphylococcus</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Stasis and mild infection of long duration</li>\n<li>Common in women aged 40-60</li>\n<li><strong>Causes:</strong> <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> factors (narrow bony canal), <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> diseases, foreign bodies, infection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Clinical Features/ Sequelae</strong></p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ol>\n<li><strong>Stage of cellulitis: </strong>Painful <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> at the <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> sac, epiphora, fever, redness, and oedema.</li>\n<li><strong>Lacrimal abscess: </strong>Pus-filled sac, <span class=\"customMeta\" data-dictid=\"1adaaa6ded16927772023e7fe0c856\">fluctuant</span> swelling, may <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> forming an abscess.</li>\n<li><strong>Fistula formation: </strong>Untreated <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> leads to <span class=\"customMeta\" data-dictid=\"f71e485d131692777199151d1076d2\">spontaneous</span> discharge, forming a fistula.</li>\n</ol>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ol>\n<li><strong>Stage of chronic catarrhal dacryocystitis: </strong>Watering eye, mild redness, NLD block</li>\n<li><strong>Lacrimal mucocele: </strong>Swelling below inner canthus, <span class=\"customMeta\" data-dictid=\"14f3af3bf516927771939c1efb8726\">mucoid</span> fluid regurgitation.</li>\n<li><strong>Chronic <span class=\"customMeta\" data-dictid=\"a48a50d87216927771994f1cfe9b7d\">suppurative</span> dacryocystitis: </strong>Purulent <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> (d/t infection), <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> conjunctivitis.</li>\n</ol>\n<ol>\n<li><strong>Chronic fibrotic sac: </strong>Thickened mucosa, persistent epiphora, <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> folds.</li>\n</ol>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Acute Dacryocystitis with lacrimal fistula\" data-author=\"Chaiti Aranke Waman Chavan\" data-hash=\"13167\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Acute-dacryocystitis-with-pre-septal-cellulitis-with-fistula_fig1_381056510\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/PWUz0RG0DUEfxiReyFzx1747910819.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"OP564 Chronic Dacryocystitis\" data-author=\"Alexis Mathieu 1,*,Stéphanie Baillif 2,3ORCID,Marie-Noelle Delyfer 1,4ORCID,Éric Longueville 1,Valentine Coste-Verdier 1,Jacques Lagier 2,Abdulrhman Alrabiah 2 andArnaud Martel 2,3ORCID\" data-hash=\"13168\" data-license=\"OPEN ACCESS\" data-source=\"https://www.mdpi.com/2077-0383/13/17/5129\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/giGbkRuPDXpE98NTF0jY1747910854.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Conjunctivitis, corneal ulcer, lid abscess, <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> cellulitis, rarely <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Conjunctivitis, <span class=\"customMeta\" data-dictid=\"410b701d9916927771861ac447b041\">ectropion</span> of lower lid, risk of corneal ulcers.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Treatment</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Cellulitis:</strong> Systemic antibiotics, anti-inflammatory drugs, hot fomentation.</li>\n<li><strong>Lacrimal abscess:</strong> <strong>Drainage</strong> with incision, antibiotics, possible DCT or DCR later. <strong>(Option C)</strong></li>\n<li><strong>External fistula: Fistulectomy </strong>with DCT or DCR after controlling infection.</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Conservative: </strong>Probing and syringing (early stages).</li>\n<li><strong>Dacryocystorhinostomy (DCR):</strong> Preferred surgery to re-establish <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> drainage. <strong>(Option A)</strong></li>\n<li><strong>Dacryocystectomy (DCT):</strong> Indicated if DCR is contraindicated or in cases of fibrosis, infection, or old age (&gt;60y). <strong>(Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following surgeries use this instrument?", "options": [{"label": "A", "text": "Evisceration", "correct": false}, {"label": "B", "text": "Enucleation", "correct": false}, {"label": "C", "text": "Cataract surgery", "correct": false}, {"label": "D", "text": "Dacryocystorhinostomy", "correct": true}], "correct_answer": "D. Dacryocystorhinostomy", "question_images": ["https://image.prepladder.com/notes/04QItSWRgh15Kwmm5y2M1747910928.png"], "explanation_images": ["https://image.prepladder.com/content/gOzYRmZxP0K0ixWBlNzv1745921164.png", "https://image.prepladder.com/notes/04QItSWRgh15Kwmm5y2M1747910928.png", "https://image.prepladder.com/content/hNRWbhrEn1MJxYMrwWfa1745921164.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following treatments is appropriate for a 3-month-old child with a mucopurulent discharge from the right puncta and a history of increased watering in the right eye, as noticed by the mother?", "options": [{"label": "A", "text": "Syringing", "correct": false}, {"label": "B", "text": "Probing with syringing", "correct": false}, {"label": "C", "text": "Sac massage with topical antibiotics", "correct": true}, {"label": "D", "text": "Dacryocystorhinostomy", "correct": false}], "correct_answer": "C. Sac massage with topical antibiotics", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:556px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>&lt; 6-9 months</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Lacrimal <span class=\"customMeta\" data-dictid=\"59ae5630de16927771988a866d1dea\">sac</span> <span class=\"customMeta\" data-dictid=\"c515f6a71d16927771919f574f1ee9\">massage</span> with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> antibiotics (Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>9 months - 4 years</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bowman’s probing with syringing <strong>(Option A) (Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>&gt; 4 years </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dacryocystorhinostomy <strong>(Option D)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old woman is being counseled for surgery for her long-standing dacryocystitis. Which of the following is the surgery of choice?", "options": [{"label": "A", "text": "Dacryocystorhinostomy", "correct": true}, {"label": "B", "text": "Dacryocystectomy", "correct": false}, {"label": "C", "text": "Probing", "correct": false}, {"label": "D", "text": "Balloon catheter dilation", "correct": false}], "correct_answer": "A. Dacryocystorhinostomy", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/iOuNWdU3H3MFjChfd3xu1746700636.png", "https://image.prepladder.com/content/eAczuIhj2MHkoxr91WaP1746700626.png"], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"eaea364ab91692777185bcc8181eff\"&gt;Dacryocystorhinostomy&lt;/span&gt; (DCR)</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Acute Dacryocystitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Chronic Dacryocystitis</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Aetiology</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"b5a5dcf4021692777187e3c0d2d47d\">exacerbation</span> of chronic dacryocystitis</li>\n<li>Spread from neighbouring infected structures (e.g., sinuses, bones, <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> abscess)</li>\n<li><strong>Causative organisms: </strong>Streptococcus haemolyticus, Pneumococcus, Staphylococcus</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Stasis and mild infection of long duration</li>\n<li>Common in women aged 40-60</li>\n<li>Causes: <span class=\"customMeta\" data-dictid=\"116f86834a1692777181a914379270\">anatomical</span> factors (narrow bony canal), <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> diseases, foreign bodies, infection.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Clinical Features/ Sequelae</strong></p>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ol>\n<li><strong>Stage of cellulitis: </strong>Painful <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> at the <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> sac, epiphora, fever, redness, and oedema.</li>\n<li><strong>Lacrimal abscess: </strong>Pus-filled sac, <span class=\"customMeta\" data-dictid=\"1adaaa6ded16927772023e7fe0c856\">fluctuant</span> swelling, may <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> forming an abscess.</li>\n<li><strong>Fistula formation: </strong>Untreated <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> leads to <span class=\"customMeta\" data-dictid=\"f71e485d131692777199151d1076d2\">spontaneous</span> discharge, forming a fistula.</li>\n</ol>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ol>\n<li><strong>Stage of chronic catarrhal dacryocystitis: </strong>Watering eye, mild redness, NLD block</li>\n<li><strong>Lacrimal mucocele: </strong>Swelling below inner canthus, <span class=\"customMeta\" data-dictid=\"14f3af3bf516927771939c1efb8726\">mucoid</span> fluid regurgitation.</li>\n<li><strong>Chronic <span class=\"customMeta\" data-dictid=\"a48a50d87216927771994f1cfe9b7d\">suppurative</span> dacryocystitis: </strong>Purulent <span class=\"customMeta\" data-dictid=\"9dd87431ba1692777186ecfb21d258\">discharge</span> (d/t infection), <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> conjunctivitis.</li>\n</ol>\n<ol>\n<li><strong>Chronic fibrotic sac: </strong>Thickened mucosa, persistent epiphora, <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> folds.</li>\n</ol>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author='\"Chaiti Aranke Waman Chavan\"' data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Acute-dacryocystitis-with-pre-septal-cellulitis-with-fistula_fig1_381056510\" data-tags=\"\" height=\"305\" src=\"https://image.prepladder.com/content/iOuNWdU3H3MFjChfd3xu1746700636.png\" width=\"376\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Alexis Mathieu 1,*,Stéphanie Baillif 2,3ORCID,Marie-Noelle Delyfer 1,4ORCID,Éric Longueville 1,Valentine Coste-Verdier 1,Jacques Lagier 2,Abdulrhman Alrabiah 2 andArnaud Martel 2,3ORCID\" data-hash=\"\" data-license=\"OPEN ACCESS\" data-source=\"https://www.mdpi.com/2077-0383/13/17/5129\" data-tags=\"\" height=\"378\" src=\"https://image.prepladder.com/content/eAczuIhj2MHkoxr91WaP1746700626.png\" width=\"352\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Conjunctivitis, corneal ulcer, lid abscess, <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> cellulitis, rarely <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Conjunctivitis, <span class=\"customMeta\" data-dictid=\"410b701d9916927771861ac447b041\">ectropion</span> of lower lid, risk of corneal ulcers.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Treatment</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Cellulitis:</strong> Systemic antibiotics, anti-inflammatory drugs, hot fomentation.</li>\n<li><strong>Lacrimal abscess:</strong> <span class=\"customMeta\" data-dictid=\"dd824a31e71692777186c7f8168998\">Drainage</span> with incision, antibiotics, possible DCT or DCR later.</li>\n<li><strong>External fistula: </strong>Fistulectomy with DCT or DCR after controlling infection.</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Conservative: </strong>Probing and syringing (early stages).</li>\n<li><strong>Dacryocystorhinostomy (DCR):</strong> Preferred surgery to re-establish <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> drainage.</li>\n<li><strong>Dacryocystectomy (DCT):</strong> Indicated if DCR is contraindicated or in cases of fibrosis, infection, or old age.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In Dacryocystorhinostomy (DCR), the point of opening of the lacrimal sac is into which nasal meatus?", "options": [{"label": "A", "text": "Inferior meatus", "correct": false}, {"label": "B", "text": "Middle meatus", "correct": true}, {"label": "C", "text": "Supreme meatus", "correct": false}, {"label": "D", "text": "Superior meatus", "correct": false}], "correct_answer": "B. Middle meatus", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/3a8L9vTN6uW4BUbyWUnN1747036761.png", "https://image.prepladder.com/content/dEcqo9CZlz7bR04X9zYV1747036790.png"], "explanation": "<p>Correct Answer B - Middle meatu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old patient presents with chronic dacryocystitis . She complains of recurrent tearing, discharge, and mild swelling in the inner corner of the eye . The clinical findings and history are consistent with chronic dacryocystitis. What should be the treatment of choice for this patient ?", "options": [{"label": "A", "text": "Lacrimal sac massage", "correct": false}, {"label": "B", "text": "Dacryocystorhinostomy", "correct": true}, {"label": "C", "text": "Syringing", "correct": false}, {"label": "D", "text": "Probing", "correct": false}], "correct_answer": "B. Dacryocystorhinostomy", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Dacryocystorhinostomy: \n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Lacrimal gland is supplied through a parasympathetic system. It is supplied by which ganglion?", "options": [{"label": "A", "text": "Ciliary ganglion", "correct": false}, {"label": "B", "text": "Otic ganglion", "correct": false}, {"label": "C", "text": "Pterygopalatine ganglion", "correct": true}, {"label": "D", "text": "Submandibular ganglion", "correct": false}], "correct_answer": "C. Pterygopalatine ganglion", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"e10a7d508b16927771960a2f2fa92a\"&gt;Pterygopalatine&lt;/span&gt; ganglion: \n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In Dacryocystorhinostomy (DCR), the point of opening of the lacrimal sac is into:", "options": [{"label": "A", "text": "Inferior meatus", "correct": false}, {"label": "B", "text": "Middle meatus", "correct": true}, {"label": "C", "text": "Supreme meatus", "correct": false}, {"label": "D", "text": "Superior meatus", "correct": false}], "correct_answer": "B. Middle meatus", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Middle meatu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 24 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Nd YAG laser", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/bP2T5IwM453wOxQ0ZTec1746432535.png", "https://image.prepladder.com/content/nIFnvJGWrwKJKVij00sS1746432535.png", "https://image.prepladder.com/content/GDlJy0PepY5DxVkMjz5R1746432535.png"], "explanation": "<p>Correct Answer B - Nd YAG laser</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>M/C <span class=\"customMeta\" data-dictid=\"8f584900e71692777196a6e8943d4e\">postoperative</span> <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> following <span class=\"customMeta\" data-dictid=\"ab0f3917ce1692777187309ec78709\">extracapsular</span> lens extraction.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Posterior <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">Capsule</span> <span class=\"customMeta\" data-dictid=\"990cbfd3111692777194c6967ee125\">Opacification</span> (PCO)</strong>: Common <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of after cataract.</li>\n<li>Dense Membranous After Cataract: Thick <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> formation.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Raj, Shetal &amp; Vasavada, Abhay &amp; Johar, Kaid &amp; Vasavada, Vaishali &amp; Vasavada, Viraj.\" data-hash=\"\" data-license=\"CC BY 2.5\" data-source=\"An eye with posterior capsule opacification before (A) and after Nd:... | Download Scientific Diagram (researchgate.net)\" data-tags=\"\" height=\"312\" src=\"https://image.prepladder.com/content/bP2T5IwM453wOxQ0ZTec1746432535.png\" width=\"371\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Soemmering's Ring:</strong> Thick ring behind the iris, enclosed between <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> layers.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Peck, Travis &amp; Aggarwal, Shruti &amp; Johnson, Sandra. \" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"Slit lamp photograph of the right eye showing an incomplete ring of... | Download Scientific Diagram (researchgate.net)\" data-tags=\"\" height=\"392\" src=\"https://image.prepladder.com/content/nIFnvJGWrwKJKVij00sS1746432535.png\" width=\"537\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p> </p>\n<ul>\n<li><strong>Elschnig's Pearls:</strong> Clustered, <span class=\"customMeta\" data-dictid=\"869a7f073716927772017c4d29804a\">vacuolated</span> <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> epithelial cells along the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> capsule.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"C.Y. Lewis\" data-hash=\"\" data-license=\"CC BY-NC-ND 3.0\" data-source=\"Atlas Entry - Aftercataract (Elschnig's pearls) (eyerounds.org)\" data-tags=\"\" height=\"349\" src=\"https://image.prepladder.com/content/GDlJy0PepY5DxVkMjz5R1746432535.png\" width=\"387\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>ND YAG laser <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> capsulotomy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which laser is most commonly used for performing a laser iridotomy?", "options": [{"label": "A", "text": "Argon laser", "correct": false}, {"label": "B", "text": "Nd:YAG laser", "correct": true}, {"label": "C", "text": "Excimer laser", "correct": false}, {"label": "D", "text": "CO₂ laser", "correct": false}], "correct_answer": "B. Nd:YAG laser", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/na0egv2MCMrZsyDpIw381747035978.png"], "explanation": "<p>Correct Answer B - Nd:YAG\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Laser</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Wavelength </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical Applications</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Nd: YAG</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">1064</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Posterior capsulotomy, iridotomy, vitreolysis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Frequency-doubled Nd:YAG</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">532</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\">Retinal photocoagulation, cyclophotocoagulation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which laser is considered the most appropriate for cataract surgery?", "options": [{"label": "A", "text": "Nd-YAG", "correct": false}, {"label": "B", "text": "Diode", "correct": false}, {"label": "C", "text": "Excimer", "correct": false}, {"label": "D", "text": "Femtosecond laser", "correct": true}], "correct_answer": "D. Femtosecond laser", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - F\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "For laser iridotomy which laser is used?", "options": [{"label": "A", "text": "Argon laser", "correct": false}, {"label": "B", "text": "Nd YAG laser", "correct": true}, {"label": "C", "text": "Excimer laser", "correct": false}, {"label": "D", "text": "Co2 Laser", "correct": false}], "correct_answer": "B. Nd YAG laser", "question_images": [], "explanation_images": [], "explanation": "<p>Correct option B\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align: center;\"><strong>Type of laser</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Wavelength</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Effects produced</strong></p>\n</td>\n<td>\n<p style=\"text-align: center;\"><strong>Clinical applications</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Argon</p>\n</td>\n<td>\n<p>488 (Blue)</p>\n<p>514 (Green)</p>\n</td>\n<td>\n<p>Photocoagulation</p>\n</td>\n<td>\n<ul>\n<li>Iridoplasty</li>\n<li>Trabeculoplasty</li>\n<li>Pupillomydriasis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Krypton</p>\n</td>\n<td>\n<p>647</p>\n</td>\n<td>\n<p>Photocoagulation</p>\n</td>\n<td>\n<ul>\n<li>Retinal photocoagulation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Diode</p>\n</td>\n<td>\n<p>810</p>\n</td>\n<td>\n<p>Photocoagulation</p>\n</td>\n<td>\n<ul>\n<li>Retinal photocoagulation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>FD-YAG</p>\n</td>\n<td>\n<p>577 (Green)</p>\n</td>\n<td>\n<p>Photocoagulation</p>\n</td>\n<td>\n<ul>\n<li>Retinal photocoagulation</li>\n<li>Cyclophotocoagulation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>ND-YAG</p>\n</td>\n<td>\n<p>1064 (near infrared)</p>\n</td>\n<td>\n<p>Photo disruption</p>\n</td>\n<td>\n<ul>\n<li>Posterior capsulotomy</li>\n<li>Iridotomy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Excimer</p>\n</td>\n<td>\n<p>193 (Ultraviolet)</p>\n</td>\n<td>\n<p>Photoablation</p>\n</td>\n<td>\n<ul>\n<li>LASIK</li>\n<li>LASEK</li>\n<li>Photo-refractive <span class=\"customMeta\" data-dictid=\"8a6b591d1d16927771900a3c620d92\">keratectomy</span> (PRK)</li>\n<li>Photo-therapeutic <span class=\"customMeta\" data-dictid=\"8a6b591d1d16927771900a3c620d92\">keratectomy</span> (PTK)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p>Femtosecond</p>\n</td>\n<td>\n<p>1053 (Near-infrared)</p>\n</td>\n<td>\n<p>Photo disruption</p>\n</td>\n<td>\n<ul>\n<li>Femtosecond laser-assisted <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> surgery and <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> and full-thickness corneal transplant</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 14 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Apart from the abdominal cavity, which body part is included in e-FAST?", "options": [{"label": "A", "text": "Pelvic Cavity", "correct": false}, {"label": "B", "text": "Peripheral vessels", "correct": false}, {"label": "C", "text": "Thoracic cavity", "correct": true}, {"label": "D", "text": "Dural and subdural spaces", "correct": false}], "correct_answer": "C. Thoracic cavity", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "According to GCS, a verbal score of 1 indicates:", "options": [{"label": "A", "text": "No Verbal response", "correct": true}, {"label": "B", "text": "Inappropriate words", "correct": false}, {"label": "C", "text": "Incomprehensible sounds", "correct": false}, {"label": "D", "text": "Oriented response", "correct": false}], "correct_answer": "A. No Verbal response", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Simplified Glasgow <span class=\"customMeta\" data-dictid=\"e39842f67b1692777184171cd1852a\">Coma</span> Scale (GCS) </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Response</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Score</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Eye Opening (E)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Spontaneous</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>To speech</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>3</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>To pain</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Verbal Response (V)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Oriented</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>5 <strong>(Option D ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Confused conversation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inappropriate words</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>3 <strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Incomprehensible sounds</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2 <strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"6\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Motor Response (M)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Obeys commands</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>6</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Localizes to pain</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>5</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Withdraws from pain</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>4</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Abnormal <span class=\"customMeta\" data-dictid=\"85ff8a7ff81692777202a827961a5c\">flexion</span> (decorticate)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>3</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Abnormal extension (decerebrate)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>No response</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>1</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Most common site of peripheral aneurysm?", "options": [{"label": "A", "text": "Brachial artery", "correct": false}, {"label": "B", "text": "Popliteal artery", "correct": true}, {"label": "C", "text": "Radial artery", "correct": false}, {"label": "D", "text": "Femoral artery", "correct": false}], "correct_answer": "B. Popliteal artery", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which one of the following is absent in cases of massive blood transfusion?", "options": [{"label": "A", "text": "DIC", "correct": false}, {"label": "B", "text": "Febrile transfusion reaction", "correct": false}, {"label": "C", "text": "Hypercalcemia", "correct": true}, {"label": "D", "text": "Thrombocytopenia", "correct": false}], "correct_answer": "C. Hypercalcemia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:682px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Complications of massive blood transfusion</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Complication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Effect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypothermia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Transfusion of cold blood (stored at 4°C).</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Body temperature drops, leading to impaired <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> mechanisms (coagulopathy), and worsening bleeding.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Coagulopathy</strong></p>\n<p> </p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dilution of <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> factors and platelets due to transfusion; consumption of <span class=\"customMeta\" data-dictid=\"58c17961c71692777184ab55a9c4df\">clotting</span> factors by ongoing haemorrhage.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Impaired blood clotting, prolonged <span class=\"customMeta\" data-dictid=\"41e858bf2816927771836d46c619b9\">bleeding</span> time, thrombocytopenia, and increased risk of continued bleeding.</p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>DIC</strong></p>\n<p><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Due to the release of <span class=\"customMeta\" data-dictid=\"ff2094828c1692777196941a65e6eb\">procoagulant</span> substances</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Leads to haemorrhage due to depleted <span class=\"customMeta\" data-dictid=\"7414bd02f216927771889b3e159ef4\">hemostatic</span> components, tissue hypoxia, and <span class=\"customMeta\" data-dictid=\"77aed446d2169277719007f42bf052\">infarction</span> due to microthrombi, or both.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Citrate Toxicity</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Large volumes of transfused blood contain citrate, which binds to calcium.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypocalcemia leads to muscle cramps, seizures, and <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypocalcemia</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Packed red blood cells (PRBCs) and other blood products are preserved with <strong>citrate</strong>, an anticoagulant.</li>\n<li>Citrate binds to <strong>ionised calcium</strong> (Ca²⁺) in the recipient's blood, reducing the free <span class=\"customMeta\" data-dictid=\"54de8b79a91692777183e608bc0dd4\">calcium</span> level - <strong>hypocalcemia</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Presents as muscle spasms, <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias, and decreased myocardial contractility</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hyperkalemia</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Potassium leaks from stored red blood cells into <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> during storage.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Elevated <span class=\"customMeta\" data-dictid=\"a995a613a016927771969d4395dc80\">potassium</span> levels (hyperkalemia) can cause <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias, potentially leading to <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrest.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hypokalemia</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Potassium may shift intracellularly once transfused red blood cells are metabolically revived.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hypokalemia causes muscle weakness, paralysis, and <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> arrhythmias.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Metabolic Alkalosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rapid <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> of <span class=\"customMeta\" data-dictid=\"3569209ba41692777184f88db9316d\">citrate</span> into bicarbonate.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increased pH (alkalosis) can lead to muscle twitching, irritability, and impaired oxygen release from haemoglobin.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Metabolic Acidosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inadequate tissue <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> leads to <span class=\"customMeta\" data-dictid=\"b82539c9ae1692777191a3f7ddd7bb\">lactic</span> acid accumulation.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lowered blood pH (acidosis) leads to confusion, fatigue, rapid breathing, and worsened <span class=\"customMeta\" data-dictid=\"e2b5f013011692777183ea1b11ed9c\">cardiovascular</span> function.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Transfusion Related <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">Acute</span> Lung Injury (TRALI)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Antibodies in transfused blood <span class=\"customMeta\" data-dictid=\"dddc752e1716927771807f985bb8bb\">activate</span> the recipient's immune response, causing <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and fluid buildup in the lungs.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Non-cardiogenic <span class=\"customMeta\" data-dictid=\"10e2dee19e1692777196673db90c23\">pulmonary</span> oedema, presenting as <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"cfad80a0f716927771979aae100f95\">respiratory</span> <span class=\"customMeta\" data-dictid=\"afafb9026e1692777186e3dd168fa8\">distress</span> with <span class=\"customMeta\" data-dictid=\"a249eeb5551692777189661d39c1b2\">hypoxia</span> within 6 hours of transfusion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Transfusion Associated Circulatory <span class=\"customMeta\" data-dictid=\"9d02a99d051692777194aa3375023b\">Overload</span> (TACO)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Volume of transfused blood exceeds the patient’s capacity to manage, leading to fluid overload.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pulmonary oedema, shortness of breath, hypertension, and signs of heart failure.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Iron Overload</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Repeated transfusions lead to excessive accumulation of iron.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Iron deposits in organs (e.g., liver, heart, pancreas), lead to organ damage and failure over time.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Hemolytic Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>ABO or Rh incompatibility.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Rapid destruction of red blood cells (hemolysis), causes fever, chills, hemoglobinuria, and potentially <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"b9356afdba16927771979d068c6587\">renal</span> failure or shock.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Allergic Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reaction to proteins in transfused blood products.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Symptoms range from mild itching, rash, or <span class=\"customMeta\" data-dictid=\"14ccc7cf1c1692777189d4fb9d1fb5\">hives</span> to severe <span class=\"customMeta\" data-dictid=\"d6d717efa216927771819fee139235\">anaphylaxis</span> (airway constriction, low blood pressure, shock).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bacterial Contamination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Blood products are contaminated during collection or storage.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sepsis, characterized by fever, chills, low blood pressure, and possibly <span class=\"customMeta\" data-dictid=\"39f67d7dde16927771985d3952058d\">septic</span> shock.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Febrile <span class=\"customMeta\" data-dictid=\"cbb73554631692777200444a9ea263\">transfusion</span> reaction</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>It is a non-hemolytic condition that is not completely understood but is believed to be caused by <span class=\"customMeta\" data-dictid=\"a459f313d9169277719789fdfb7ada\">residual</span> white blood cells in the blood unit or cytokines that accumulate during storage.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Fever, rigour, chills</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements about ranula is FALSE?", "options": [{"label": "A", "text": "Mucus extravasation cyst", "correct": false}, {"label": "B", "text": "Arises from submandibular salivary gland", "correct": true}, {"label": "C", "text": "Bluish, translucent cystic swelling on the floor of the mouth", "correct": false}, {"label": "D", "text": "Marsupialization or excision is the treatment", "correct": false}], "correct_answer": "B. Arises from submandibular salivary gland", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/akYmkU4Zg2U6E2ZO9wmY1747024988.png", "https://image.prepladder.com/content/GNogQfMmb7mub03r2GvM1747024988.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:622px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black\">\n<p><strong>Ranula</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Definition</strong></p>\n<p><strong>(Options A &amp; C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Ranulas are a type of <strong>extravasation mucocele</strong>, caused by the <span class=\"customMeta\" data-dictid=\"e73553a3a5169277719787fd5f4680\">rupture</span> of the main <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> or obstructed <span class=\"customMeta\" data-dictid=\"4e0948603216927771801829c2c085\">acini</span> of the <strong>sublingual gland</strong>.</li>\n<li>They appear as <strong>bluish, translucent, <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> on the floor of the mouth</strong> and resemble the belly of a frog.</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Ph0t0happy\" data-hash=\"\" data-license=\"CC-BY-SA-3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Ranula_human_09.jpg\" data-tags=\"\" height=\"513\" src=\"https://image.prepladder.com/content/akYmkU4Zg2U6E2ZO9wmY1747024988.png\" width=\"573\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Commonly found in the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> floor of the mouth.</li>\n<li>When it extends through the <span class=\"customMeta\" data-dictid=\"d0922475bc1692777193d420470423\">mylohyoid</span> muscle, it presents as a <span class=\"customMeta\" data-dictid=\"a94c9109b016927771997aa2985457\">submental</span> <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> known as a<strong> \"plunging ranula.\"</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<p>Typically soft, fluctuant, and painless unless infected.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li>Confirmed through Magnetic Resonance Imaging (MRI)</li>\n<li>Ultrasound</li>\n<li>Aspiration of thick, sticky <span class=\"customMeta\" data-dictid=\"6b0184a84d16927771981289924c2a\">saliva</span> differentiates it from a lymphangioma.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none\">\n<p><strong>Treatment</strong></p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none\">\n<ul>\n<li><strong>Excision of the <span class=\"customMeta\" data-dictid=\"75089cc39e1692777199b8933bd249\">sublingual</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> is preferred. </strong></li>\n<li>Incision, drainage, and marsupialisation have low success rates. Although <strong>marsupialisation</strong> is often adequate, it has a higher <span class=\"customMeta\" data-dictid=\"1d849ebc9b1692777197d4af1fa8d2\">recurrence</span> rate compared to <span class=\"customMeta\" data-dictid=\"75089cc39e1692777199b8933bd249\">sublingual</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> excision.</li>\n<li>OK-432 injection</li>\n<li>Botulinum <span class=\"customMeta\" data-dictid=\"41329dc9381692777200a9b6d57cf4\">toxin</span> injections</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"534\" src=\"https://image.prepladder.com/content/GNogQfMmb7mub03r2GvM1747024988.png\" width=\"534\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a patient who is taking steroids for psoriasis and is experiencing a low-grade fever only at night, weight loss, and an ulcer on her neck with undermined edges, as depicted in the provided image?", "options": [{"label": "A", "text": "Psoriasis flare-up", "correct": false}, {"label": "B", "text": "Tubercular lymphadenitis", "correct": true}, {"label": "C", "text": "Lymphosarcoma", "correct": false}, {"label": "D", "text": "Syphilis", "correct": false}], "correct_answer": "B. Tubercular lymphadenitis", "question_images": ["https://image.prepladder.com/notes/1TH1dju86skmeaqbBBxB1747998760.png"], "explanation_images": ["https://image.prepladder.com/content/fEc4u0perN8HZQL6yWkS1747025426.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:688px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Lymph <span class=\"customMeta\" data-dictid=\"b10ce4acbf169277719323ffd12306\">Node</span> TB (Tuberculous Lymphadenitis)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Most common</strong> <span class=\"customMeta\" data-dictid=\"728e7607f31692777187291e007a0b\">extrapulmonary</span> TB presentation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Risk Groups</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>HIV-positive individuals, Immunosuppressive individuals, children, and non-Caucasian women.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Causative Organism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Previously M. bovis; now mainly M. tuberculosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Painless </strong>swelling in <span class=\"customMeta\" data-dictid=\"4df97a6cbf169277719172fd1af767\">lymph</span> nodes, usually <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"25c6ce766c1692777184ab9a40305c\">cervical</span> or <span class=\"customMeta\" data-dictid=\"53765334f31692777199cf434360de\">supraclavicular</span> (historically called scrofula).</li>\n<li><strong>Early disease: Discrete nodes</strong></li>\n<li>Advanced disease: Matted, nontender mass, possible <span class=\"customMeta\" data-dictid=\"10df63cea41692777203b470341d21\">fistula</span> draining <span class=\"customMeta\" data-dictid=\"99368d5fef1692777183ea405bed67\">caseous</span> material.</li>\n<li>Pulmonary disease in &lt;50% of cases.</li>\n<li>Systemic symptoms are uncommon except in HIV-positive patients.</li>\n<li>Non-specific reaction → Matting → Cold <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">Abscess</span> → Collar stud <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> → Sinus formation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Fine-needle <span class=\"customMeta\" data-dictid=\"831d67ad8a1692777182763ca62e4b\">aspiration</span> <span class=\"customMeta\" data-dictid=\"754ab07a2e1692777183ed178c883d\">biopsy</span> (80% yield) or <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> biopsy.</strong></li>\n<li>Granulomatous lesions may or may not contain AFBs.</li>\n<li>Cultures are positive in 70–80% of cases.</li>\n<li>HIV-positive patients: Poorly organised or absent granulomas; higher bacterial loads increase <span class=\"customMeta\" data-dictid=\"552e9ef8811692777186997018b858\">diagnostic</span> yield.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Differential Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Infectious diseases</li>\n<li>Lymphomas</li>\n<li>Metastatic carcinomas</li>\n<li>Rare disorders: Kikuchi’s disease, Kimura’s disease, Castleman’s disease.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old woman comes to the OPD with a history of a lump in the left breast. On clinical examination, the size of the lump in the left breast is 9x10 cm with the following appearance and no axillary lymphadenopathy. The histopathology of the biopsy from the lump shows increased stromal cellularity and typical leaflike architecture. What is your likely diagnosis?", "options": [{"label": "A", "text": "Phyllodes tumour", "correct": true}, {"label": "B", "text": "Giant fibroadenoma", "correct": false}, {"label": "C", "text": "Inflammatory carcinoma", "correct": false}, {"label": "D", "text": "Ductal carcinoma", "correct": false}], "correct_answer": "A. Phyllodes tumour", "question_images": ["https://image.prepladder.com/content/d79JUMsTq9YVRORpAoQE1747116110.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the diagnosis from the given abdominal x-ray?", "options": [{"label": "A", "text": "Ureterocoele", "correct": false}, {"label": "B", "text": "Pelvic bone fracture", "correct": false}, {"label": "C", "text": "Rectal foreign body", "correct": true}, {"label": "D", "text": "Bladder stone", "correct": false}], "correct_answer": "C. Rectal foreign body", "question_images": ["https://image.prepladder.com/content/MyC6v9qsXI7vAK7gc0TR1748163282.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 18 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 45-year-old patient presents with headaches and transient blurred vision. Fundoscopy reveals optic disc swelling with indistinct margins and engorged veins. What is the most accurate explanation for the pathogenesis of this condition?", "options": [{"label": "A", "text": "Compression of the central retinal vein.", "correct": false}, {"label": "B", "text": "Increased CSF pressure causes axoplasmic stasis.", "correct": true}, {"label": "C", "text": "Inflammation of the optic nerve head.", "correct": false}, {"label": "D", "text": "Increased intraocular pressure.", "correct": false}], "correct_answer": "B. Increased CSF pressure causes axoplasmic stasis.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mxXzSS8k0ccTFR0XOIzw1747899882.mp3", "video": ""}, {"text": "Latent nystagmus is seen in which of the below mentioned condition?", "options": [{"label": "A", "text": "Infantile esotropia", "correct": true}, {"label": "B", "text": "Arnold-Chiari malformation", "correct": false}, {"label": "C", "text": "Internuclear ophthalmoplegia", "correct": false}, {"label": "D", "text": "Cerebellopontine angle tumours", "correct": false}], "correct_answer": "A. Infantile esotropia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old woman presents with impaired adduction of the left eye on rightward gaze, and the abducting eye shows ataxic nystagmus. There is no noticeable ptosis, and the convergence remains intact. MRI shows a lesion in the brainstem affecting the medial longitudinal fasciculus. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Internuclear ophthalmoplegia", "correct": true}, {"label": "B", "text": "One-and-a-half syndrome", "correct": false}, {"label": "C", "text": "Oculomotor nerve palsy", "correct": false}, {"label": "D", "text": "Lateral rectus palsy", "correct": false}], "correct_answer": "A. Internuclear ophthalmoplegia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qSxB9HqYz4DVgiaMySxV1747923771.mp3", "video": ""}, {"text": "A 60-year-old woman presents with difficulty moving her eyes to the right. On examination, she is unable to gaze to the right, but has normal eye movements when gazing to the left, up, and down. There is no weakness in the limbs or facial muscles. Which of the following is the most likely location of the lesion?", "options": [{"label": "A", "text": "Left abducens nucleus", "correct": false}, {"label": "B", "text": "Paramedian pontine reticular formation", "correct": true}, {"label": "C", "text": "Trochlear nerve", "correct": false}, {"label": "D", "text": "Right oculomotor nucleus", "correct": false}], "correct_answer": "B. Paramedian pontine reticular formation", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XrTa5sv7tXSnPWHDi7wA1748275426.mp3", "video": ""}, {"text": "A 32-year-old woman presents with blurred vision in her right eye, photophobia and notices that her right pupil appears larger than the left. On examination, her right pupil is mid-dilated and reacts very sluggishly to light and has a sluggish and tonic reaction to accommodation. The left pupil appears normal. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Horner’s syndrome", "correct": false}, {"label": "B", "text": "Adie’s tonic pupil", "correct": true}, {"label": "C", "text": "Third nerve palsy", "correct": false}, {"label": "D", "text": "Acute angle-closure glaucoma", "correct": false}], "correct_answer": "B. Adie’s tonic pupil", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mkvCs0XzymKeLv6nImGY1747924485.mp3", "video": ""}, {"text": "A 30-year-old male has difficulty distinguishing between red and green colours. His occupation requires accurate colour perception. Which of the following is the most appropriate test to quantify and classify the severity of his red-green colour vision deficiency?", "options": [{"label": "A", "text": "Ishihara colour plates", "correct": false}, {"label": "B", "text": "Farnsworth-Munsell 100-Hue Test", "correct": false}, {"label": "C", "text": "Nagel Anomaloscope", "correct": true}, {"label": "D", "text": "Lantern Test", "correct": false}], "correct_answer": "C. Nagel Anomaloscope", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pl8SIbtmy2Ah3XBjhfwE1743133234.png", "https://image.prepladder.com/notes/dtF8Smg38hzJyuiTcQdM1743133308.png", "https://image.prepladder.com/notes/MyZi2IUFDZykLE7f4Q0w1743133380.png", "https://image.prepladder.com/notes/rSwadolB4AvHkAMw1Igz1743133444.png"], "explanation": "<p><strong>References:</strong></p>\n<ul><li>↳ Test Procedure Evaluation Applications</li><li>↳ Test</li><li>↳ Test</li><li>↳ Test</li><li>↳ Procedure</li><li>↳ Procedure</li><li>↳ Procedure</li><li>↳ Evaluation</li><li>↳ Evaluation</li><li>↳ Evaluation</li><li>↳ Applications</li><li>↳ Applications</li><li>↳ Applications</li><li>↳ Lantern Tests (Option D) Individuals identify various coloured lights emitted from a lantern. The accuracy of colour identification is evaluated. Used in occupations requiring accurate colour vision (e.g., aviation, maritime). Example: Edridge-Green lantern.</li><li>↳ Lantern Tests (Option D)</li><li>↳ Lantern Tests</li><li>↳ Lantern Tests</li><li>↳ (Option D)</li><li>↳ (Option D)</li><li>↳ Individuals identify various coloured lights emitted from a lantern.</li><li>↳ Individuals identify various coloured lights emitted from a lantern.</li><li>↳ The accuracy of colour identification is evaluated.</li><li>↳ The accuracy of colour identification is evaluated.</li><li>↳ Used in occupations requiring accurate colour vision (e.g., aviation, maritime). Example: Edridge-Green lantern.</li><li>↳ Used in occupations requiring accurate colour vision (e.g., aviation, maritime).</li><li>↳ Example: Edridge-Green lantern.</li><li>↳ Farnsworth-Munsell 100-Hue Test (Option B) Measures ability to differentiate between subtle colour differences using hue arrangements. A higher error score indicates poorer colour vision. Detects fine colour discrimination errors. Often used to assess toxic optic neuropathy .</li><li>↳ Farnsworth-Munsell 100-Hue Test (Option B)</li><li>↳ Farnsworth-Munsell 100-Hue Test</li><li>↳ Farnsworth-Munsell 100-Hue Test</li><li>↳ (Option B)</li><li>↳ (Option B)</li><li>↳ Measures ability to differentiate between subtle colour differences using hue arrangements.</li><li>↳ Measures ability to differentiate between subtle colour differences using hue arrangements.</li><li>↳ A higher error score indicates poorer colour vision.</li><li>↳ A higher error score indicates poorer colour vision.</li><li>↳ Detects fine colour discrimination errors. Often used to assess toxic optic neuropathy .</li><li>↳ Detects fine colour discrimination errors. Often used to assess toxic optic neuropathy .</li><li>↳ toxic optic neuropathy</li><li>↳ Ishihara Color Plates (Option A) Coloured dots form numbers or patterns designed to challenge individuals with specific deficiencies. Based on the ability to correctly identify numbers or patterns formed by dots of different colours. Primarily detects red-green colour blindness. Hardy-Rand-Ritter (H-R-R) plates can detect blue-yellow deficiencies .</li><li>↳ Ishihara Color Plates (Option A)</li><li>↳ Ishihara Color Plates</li><li>↳ Ishihara Color Plates</li><li>↳ (Option A)</li><li>↳ (Option A)</li><li>↳ Coloured dots form numbers or patterns designed to challenge individuals with specific deficiencies.</li><li>↳ Coloured dots form numbers or patterns designed to challenge individuals with specific deficiencies.</li><li>↳ Based on the ability to correctly identify numbers or patterns formed by dots of different colours.</li><li>↳ Based on the ability to correctly identify numbers or patterns formed by dots of different colours.</li><li>↳ Primarily detects red-green colour blindness. Hardy-Rand-Ritter (H-R-R) plates can detect blue-yellow deficiencies .</li><li>↳ Primarily detects red-green colour blindness. Hardy-Rand-Ritter (H-R-R) plates can detect blue-yellow deficiencies .</li><li>↳ red-green</li><li>↳ blue-yellow deficiencies</li><li>↳ Anomaloscope (Nagel, Pickford-Nicolson) Split visual field: adjust red and green lights to match a yellow field. Determines severity and type of red-green colour vision deficiency through light adjustments. Nagel Anomaloscope for red-green anomalies. Pickford-Nicolson for blue-yellow anomalies.</li><li>↳ Anomaloscope (Nagel, Pickford-Nicolson)</li><li>↳ Anomaloscope (Nagel, Pickford-Nicolson)</li><li>↳ Anomaloscope (Nagel, Pickford-Nicolson)</li><li>↳ Split visual field: adjust red and green lights to match a yellow field.</li><li>↳ Split visual field: adjust red and green lights to match a yellow field.</li><li>↳ Determines severity and type of red-green colour vision deficiency through light adjustments.</li><li>↳ Determines severity and type of red-green colour vision deficiency through light adjustments.</li><li>↳ Nagel Anomaloscope for red-green anomalies. Pickford-Nicolson for blue-yellow anomalies.</li><li>↳ Nagel Anomaloscope for red-green anomalies. Pickford-Nicolson for blue-yellow anomalies.</li><li>↳ Nagel Anomaloscope</li><li>↳ Pickford-Nicolson</li><li>↳ Holmgren’s Wools Test Subject is asked to make a series of colour-matches from a selection of skeins of coloured wools. Based on the ability to correctly match the samples with the reference colours provided. Originally designed to screen red-green colour blindness. Although not a suitable screening test.</li><li>↳ Holmgren’s Wools Test</li><li>↳ Holmgren’s Wools Test</li><li>↳ Holmgren’s Wools Test</li><li>↳ Subject is asked to make a series of colour-matches from a selection of skeins of coloured wools.</li><li>↳ Subject is asked to make a series of colour-matches from a selection of skeins of coloured wools.</li><li>↳ Based on the ability to correctly match the samples with the reference colours provided.</li><li>↳ Based on the ability to correctly match the samples with the reference colours provided.</li><li>↳ Originally designed to screen red-green colour blindness. Although not a suitable screening test.</li><li>↳ Originally designed to screen red-green colour blindness. Although not a suitable screening test.</li></ul>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:670px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Evaluation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Applications</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lantern Tests</strong></p>\n<p><strong>(Option D)</strong></p>\n<p><img alt=\"Lantern test\" data-author=\"NA\" data-hash=\"4226\" data-license=\"NA\" data-source=\"https://www.color-blind-test.com/lantern-color-blind-test-more.html\" data-tags=\"March2025\" height=\"431\" src=\"https://image.prepladder.com/notes/pl8SIbtmy2Ah3XBjhfwE1743133234.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Individuals identify various coloured lights emitted from a lantern.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The accuracy of colour identification is evaluated.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Used in occupations requiring accurate colour vision (e.g., aviation, maritime).</p>\n\t\t\t \n\n\t\t\t<p>Example: Edridge-Green lantern.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Farnsworth-Munsell 100-Hue Test</strong></p>\n<p><strong>(Option B)</strong></p>\n<p><img alt=\"Farnsworth-Munsell 100-Hue Test\" data-author=\"Gabriela P. \" data-hash=\"4227\" data-license=\"CC BY 4.0\" data-source=\"https://en.wikipedia.org/wiki/Farnsworth%E2%80%93Munsell_100_hue_test#/media/File:Farnsworth%E2%80%93Munsell_Hue_Color_Vision_Test,_Material_and_Finishing_Laboratory.jpg\" data-tags=\"March2025\" height=\"392\" src=\"https://image.prepladder.com/notes/dtF8Smg38hzJyuiTcQdM1743133308.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Measures ability to <span class=\"customMeta\" data-dictid=\"c9001edbf216927771860f3475b44c\">differentiate</span> between subtle colour differences using hue arrangements.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A higher error score indicates poorer colour vision.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Detects fine colour discrimination errors. Often used to assess <strong>toxic <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuropathy</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ishihara Color Plates</strong></p>\n<p><strong>(Option A)</strong></p>\n<p><img alt=\"Ischiara Chart\" data-author=\"Wellcome Library, London\" data-hash=\"4228\" data-license=\"CC BY 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Eight_Ishihara_charts_for_testing_colour_blindness,_Europe_Wellcome_L0059163.jpg\" data-tags=\"March2025\" height=\"258\" src=\"https://image.prepladder.com/notes/MyZi2IUFDZykLE7f4Q0w1743133380.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Coloured dots <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> numbers or patterns designed to challenge individuals with specific deficiencies.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Based on the ability to correctly identify numbers or patterns formed by dots of different colours.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primarily detects <strong>red-green</strong> colour blindness. Hardy-Rand-Ritter (H-R-R) plates can detect <strong>blue-yellow deficiencies</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anomaloscope (Nagel, Pickford-Nicolson)</strong></p>\n<p><img alt=\"Anomaloscope-01\" data-author=\"NA\" data-hash=\"4229\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/rSwadolB4AvHkAMw1Igz1743133444.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Split visual field: adjust red and green lights to match a yellow field.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Determines severity and type of red-green colour vision <span class=\"customMeta\" data-dictid=\"209b85faf71692777185767d43e3bd\">deficiency</span> through light adjustments.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nagel Anomaloscope</strong> for red-green anomalies. <strong>Pickford-Nicolson</strong> for blue-yellow anomalies.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Holmgren’s Wools Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Subject is asked to make a series of colour-matches from a selection of skeins of coloured wools.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Based on the ability to correctly match the samples with the reference colours provided.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Originally designed to screen red-green colour blindness. Although not a suitable screening test.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wQWcFE8YGq9C6ZKg7mTF1746456408.mp3", "video": ""}, {"text": "On examination, a 45-year-old male was found to have repetitive, involuntary horizontal eye movements after looking at a moving striped pattern. He reports no dizziness, and his neurological examination is otherwise unremarkable. The phenomenon he is experiencing is most likely due to which of the following?", "options": [{"label": "A", "text": "Gaze-evoked nystagmus", "correct": false}, {"label": "B", "text": "Vestibular Nystagmus", "correct": false}, {"label": "C", "text": "Optokinetic Nystagmus", "correct": true}, {"label": "D", "text": "Pendular Nystagmus", "correct": false}], "correct_answer": "C. Optokinetic Nystagmus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/iabIADAgbxW27QikI5Qh1743133056.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2MHkjfweJB2UfztlcI1b1747925204.mp3", "video": ""}, {"text": "A 45-year-old male presents with difficulty moving his eyes upward and convergence-retraction nystagmus triggered by an upward gaze. His pupils react poorly to light but constrict normally when focusing on near objects. Which of the following syndromes is most likely?", "options": [{"label": "A", "text": "Parinaud syndrome", "correct": true}, {"label": "B", "text": "Weber syndrome", "correct": false}, {"label": "C", "text": "Benedict syndrome", "correct": false}, {"label": "D", "text": "Millard-Gubler syndrome", "correct": false}], "correct_answer": "A. Parinaud syndrome", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/NpCScT7YLnA4t0P0q3Jf1743132838.png", "https://image.prepladder.com/notes/kVxtAhbT6Jy770KFaLky1743132909.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QsXqI2fVxIsCMNhmsEh21747925671.mp3", "video": ""}, {"text": "A 50-year-old female patient with anisocoria had cocaine drops applied to both eyes. After 60 minutes, the anisocoria increased. To determine whether the lesion is preganglionic or postganglionic, what is the next step in the diagnostic process?", "options": [{"label": "A", "text": "Reapply cocaine drops", "correct": false}, {"label": "B", "text": "0.5% Apraclonidine", "correct": false}, {"label": "C", "text": "Adrenaline", "correct": false}, {"label": "D", "text": "1% hydroxyamphetamine", "correct": true}], "correct_answer": "D. 1% hydroxyamphetamine", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3B2DtZNuiyGiTVQtFNGA1747926512.mp3", "video": ""}, {"text": "A 48-year-old male with a history of untreated syphilis from several years ago now presents with memory loss, irritability, difficulty walking, and blurred vision. What type of pupil abnormality could be observed in this patient?", "options": [{"label": "A", "text": "Marcus Gunn pupil", "correct": false}, {"label": "B", "text": "Amaurotic Pupil", "correct": false}, {"label": "C", "text": "Adie’s Pupil", "correct": false}, {"label": "D", "text": "Argyll Robertson Pupil", "correct": true}], "correct_answer": "D. Argyll Robertson Pupil", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:735px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Reaction </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amaurotic light reflex</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absence of direct light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the affected side and an absence of <span class=\"customMeta\" data-dictid=\"14af60d32316927771855b142ca3ca\">consensual</span> light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the normal side.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> lesions</strong> on the affected side</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Efferent <span class=\"customMeta\" data-dictid=\"3aa5abc2fa169277719488e088076d\">pathway</span> defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absence of both direct and <span class=\"customMeta\" data-dictid=\"14af60d32316927771855b142ca3ca\">consensual</span> light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the affected side and presence of both direct and <span class=\"customMeta\" data-dictid=\"14af60d32316927771855b142ca3ca\">consensual</span> light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the normal side. Near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is also absent on the affected side.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Parasympatholytic drugs (e.g. atropine, homatropine)</li>\n<li>Internal ophthalmoplegia</li>\n<li>Third-nerve paralysis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Marcus Gunn <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> or RAPD </strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The pupils paradoxically <span class=\"customMeta\" data-dictid=\"7e9bc153d616927771866a8608d1a5\">dilate</span> when the flashlight is swung from the unaffected to the affected eye due to the decreased light perception.</li>\n<li>It is the first sign of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve disorder.</li>\n<li>Tested by a swinging flashlight test.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Incomplete <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve lesions (Optic neuritis) and severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> diseases (Retinopathy, CRVO)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adie’s Pupil</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Reaction to light is absent, and the near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is very slow and tonic.</li>\n<li>It is usually unilateral, associated with absent knee <span class=\"customMeta\" data-dictid=\"b88c1802e21692777190700ee5b998\">jerk</span> and occurs more often in young women.</li>\n<li>It shows pupillary <span class=\"customMeta\" data-dictid=\"4880e9b3761692777185e64eba797c\">constriction</span> to 0.125% Pilocarpine due to <span class=\"customMeta\" data-dictid=\"c35382d7d61692777185a1eeeb333c\">denervation</span> supersensitivity.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Postganglionic <span class=\"customMeta\" data-dictid=\"8f19a37b5916927771941ba9f5ef49\">parasympathetic</span> <span class=\"customMeta\" data-dictid=\"c9fe973c1116927771960115521e92\">pupillomotor</span> damage.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Argyll Robertson <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">Pupil</span> (ARP)</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reaction to near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is present, but light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> (both direct and consensual) is absent, i.e. there is light near dissociation.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neurosyphilis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Wernicke's hemianopic pupil</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is absent when light is thrown on the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> half of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> of the affected side and the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> half of the opposite side, while it is present when the light is thrown on the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> half of the affected side and the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> half of the opposite side.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> lesion</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IhXEUBmGHPcqdV0oLJ1z1747903133.mp3", "video": ""}, {"text": "A 60-year-old patient exhibits the following pupillary responses: Light is shown in the left eye; the right pupil constricts, but the left pupil remains dilated. Light is shown in the right eye; only the right pupil constricts, while the left pupil remains dilated. Which of the following lesions is most likely responsible for this pattern of pupillary response?", "options": [{"label": "A", "text": "Left optic nerve", "correct": false}, {"label": "B", "text": "Right Edinger-Westphal nucleus", "correct": false}, {"label": "C", "text": "Left oculomotor nerve", "correct": true}, {"label": "D", "text": "Right oculomotor nerve", "correct": false}], "correct_answer": "C. Left oculomotor nerve", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/V6uJ31g2sfn2p0kPPOXl1743132427.png", "https://image.prepladder.com/notes/1uxDTZbe3fTuaddJeT0h1743132471.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:617px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Direct and <span class=\"customMeta\" data-dictid=\"14af60d32316927771855b142ca3ca\">consensual</span> reactions are lost on the affected side</li>\n<li>Both are retained on the opposite side <strong>(Option D ruled out)</strong></li>\n<li>Near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> and lid <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> remain intact.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medial Chiasma </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bitemporal hemianopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Binasal hemianopia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Tract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contralateral hemianopia; <strong>Wernicke reaction.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Proximal Optic Tract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal pupillary reactions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Central Decussation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bilateral <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> with no reaction to light but <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of near reflex, lid reflexes, and psycho-sensory reactions</li>\n<li><strong>Argyll Robertson pupil.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nuclear / Supranuclear <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">Lesion</span> </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral absolute pupillary paralysis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Third Nerve Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absolute pupillary paralysis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ciliary Ganglion Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is abolished, but the <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of the near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is sometimes followed by <span class=\"customMeta\" data-dictid=\"949f14b6e4169277720075eaacbf1f\">tonic</span> <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> (Adie pupil).</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/EsVx6sPltqcQBBvpBJmw1747901837.mp3", "video": ""}, {"text": "A 62-year-old patient with papilledema has been examined. On fundoscopic examination of the eye obscuration of major blood vessels is found on the disc &amp;amp; vessels leaving the disc, with a significant halo around the disc. According to the Frisen grading system, what is the grade of papilledema?", "options": [{"label": "A", "text": "Grade 5", "correct": false}, {"label": "B", "text": "Grade 2", "correct": false}, {"label": "C", "text": "Grade 3", "correct": false}, {"label": "D", "text": "Grade 4", "correct": true}], "correct_answer": "D. Grade 4", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/B2vArEuCxJ4H3S2lIULL1743132169.png", "https://image.prepladder.com/notes/qMSP1pMZIgq3dxOyesUp1743132218.png", "https://image.prepladder.com/notes/u6t6BRoRD3oQy1LOmeVu1743132261.png", "https://image.prepladder.com/notes/kt3WS4DT5ISYGAzKhiVO1743132326.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:645px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grading of Papilledema (Modified Frisen Scale)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade 1</strong>: C-shaped <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> nasally.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Grading of Papilledema\" data-author=\"NA\" data-hash=\"4215\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/B2vArEuCxJ4H3S2lIULL1743132169.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade 2</strong>: Circumferential <span class=\"customMeta\" data-dictid=\"95af91681416927771887742113c38\">halo</span> around the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Grading of papilledema-Circumferential halo\" data-author=\"NA\" data-hash=\"4216\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"376\" src=\"https://image.prepladder.com/notes/qMSP1pMZIgq3dxOyesUp1743132218.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade 3</strong>: Obscuration of one or more major vessels<strong> leaving the disc.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\" Grading of Papilledema\" data-author=\"NA\" data-hash=\"4217\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/u6t6BRoRD3oQy1LOmeVu1743132261.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade 4</strong>: Obscuration of major vessels <strong>on the disc.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Grading of Papilledema\" data-author=\"NA\" data-hash=\"4218\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/kt3WS4DT5ISYGAzKhiVO1743132326.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade 5</strong>:<strong> Complete obscuration of all vessels on and leaving the disc</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FVeCjtD6iWERYj7uiUVf1747901360.mp3", "video": ""}, {"text": "A 50-year-old patient presents with worsening headaches and visual disturbances. Fundoscopic examination reveals optic disc swelling. Which of the following is least likely to be associated with this condition?", "options": [{"label": "A", "text": "Increased cup-to-disc ratio", "correct": true}, {"label": "B", "text": "Enlargement of the blind spot", "correct": false}, {"label": "C", "text": "Blurring of the optic disc margins", "correct": false}, {"label": "D", "text": "Engorged and tortuous retinal veins", "correct": false}], "correct_answer": "A. Increased cup-to-disc ratio", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:599px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early Papilledema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Blurring of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc margins, disc hyperemia, and mild disc swelling.</li>\n<li>Normal <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> &amp; acuity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fully Developed Papilledema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Significant <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc elevation, <span class=\"customMeta\" data-dictid=\"2b87f64333169277718751772e06ef\">engorged</span> veins, and <span class=\"customMeta\" data-dictid=\"6906dc435d16927771955398a837bc\">peripapillary</span> haemorrhages.</li>\n<li>Transient <span class=\"customMeta\" data-dictid=\"4586eccbe71692777186e577e31829\">disturbance</span> of vision.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic Papilledema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Disc cup obliteration, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> hyperemia, and hard exudates</li>\n<li>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> decreases, &amp; Constriction of the visual field.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Late Papilledema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic atrophy, <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> disc swelling, and a grey, blurred disc appearance.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MBWZ6DJQC87GFiU0ZHbF1747900381.mp3", "video": ""}, {"text": "A 62-year-old patient presents with difficulty seeing objects in the right half of the visual field in both eyes. Based on this clinical presentation, which of the following is the most likely location of the lesion affecting the visual pathway?", "options": [{"label": "A", "text": "Left optic nerve", "correct": false}, {"label": "B", "text": "Optic chiasma", "correct": false}, {"label": "C", "text": "Left optic tract", "correct": true}, {"label": "D", "text": "Right Lateral Geniculate Body", "correct": false}], "correct_answer": "C. Left optic tract", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/eq5AIMaZYYAOI7K6qs3i1743129347.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Components of Visual Pathway</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retina</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>First-order Neurons</strong>: <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">Bipolar</span> cells in the inner nuclear layer of the retina.</li>\n<li><strong>Second-order Neurons</strong>: <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">Ganglion</span> cells in the retina; their axons <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Carries visual information from the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> to the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> chiasm.</li>\n<li>Temporal and <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> fibres of the same eye.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Partial <span class=\"customMeta\" data-dictid=\"3dfb76e26c16927771855c6df807b9\">decussation</span> occurs</li>\n<li><strong>Nasal fibres cross to the opposite side</strong><strong>,</strong> while<strong> <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> fibres remain ipsilateral.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Tract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Carries visual information from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> chiasms to the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> Gebiculate body(LGB).</li>\n<li><strong>Temporal fibres of the same eye</strong> and <strong>Nasal fibres of the opposite eye. </strong></li>\n<li>The <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> causes <strong>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> in the opposite eye</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral <span class=\"customMeta\" data-dictid=\"00b4dbe9e4169277718881a95f7864\">Geniculate</span> Body (LGB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Third Order Neurons</strong>: Relay visual information to the visual cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Radiations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Meyer's Loop</strong>: Carries information from lower <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> quadrants to the <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> part of the visual cortex.</li>\n<li><strong>Baum’s Loop (Dorsal)</strong>: Carries information from upper <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> quadrants to the superior part of the visual cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Occipital Cortex</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The primary visual <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> (V1), corresponding to<strong> Brodmann area 17,</strong> is situated on the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> side of the <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> lobe, particularly along the borders of the <strong>calcarine fissure</strong>.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/AWFIgVfoEEHvERj8nady1747892893.mp3", "video": ""}, {"text": "A 35-year-old patient with multiple sclerosis (MS) notices that her vision becomes temporarily blurred whenever she exercises. Which of the following phenomena is most likely explained by this temporary worsening of neurological symptoms due to increased body temperature?", "options": [{"label": "A", "text": "Riddoch's Phenomenon", "correct": false}, {"label": "B", "text": "Uhthoff's Phenomenon", "correct": true}, {"label": "C", "text": "Pulfrich's Phenomenon", "correct": false}, {"label": "D", "text": "Lhermitte sign", "correct": false}], "correct_answer": "B. Uhthoff's Phenomenon", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GNSNfJKeCXsMYRIllicD1747899435.mp3", "video": ""}, {"text": "A 45-year-old man presents with progressive bilateral vision loss over the past few months. He reports a history of heavy smoking and alcohol consumption. Examination reveals a centrocecal scotoma in both eyes, and fundoscopy shows mild temporal pallor of the optic discs, as shown in the image. Which of the following substances is most likely responsible for his condition?", "options": [{"label": "A", "text": "Methanol", "correct": false}, {"label": "B", "text": "Cyanide", "correct": true}, {"label": "C", "text": "Arsenic", "correct": false}, {"label": "D", "text": "Ethambutol", "correct": false}], "correct_answer": "B. Cyanide", "question_images": ["https://image.prepladder.com/notes/ikV86b0zxHVGlV60fupn1743132068.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Agents</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism of Action</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Exogenous Poisons</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tobacco (Cyanide), <span class=\"customMeta\" data-dictid=\"4331e1dd521692777187b06284eb2e\">Ethyl</span> Alcohol (Ethanol), Methyl Alcohol (Methanol), Ethylene Glycol (Antifreeze), Lead, Arsenic, Cannabis indica (Tetrahydrocannabinol), Carbon Disulfide (Industrial Solvent)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>These toxins directly affect <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve function through mitochondrial <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> or <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> toxicity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Medications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Digoxin, Disulfiram, Isoniazid, Chloroquine, Cyanide, Ethambutol, Quinine, Streptomycin, Amiodarone, Sulfasalazine, Vigabatrin</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>These drugs interfere with <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> <span class=\"customMeta\" data-dictid=\"5b1a045f5f169277719210c0ac7a1e\">metabolism</span> or have <span class=\"customMeta\" data-dictid=\"3ebe379c231692777193c0afa683ed\">neurotoxic</span> effects on the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve, leading to vision loss.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Nutritional Deficiency</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>B Vitamins (especially B12, Thiamine, Folate)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Deficiencies in these vitamins lead to nerve damage, including the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Metabolic Disorders</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diabetic ketoacidosis, Uremia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>These conditions cause <span class=\"customMeta\" data-dictid=\"d92cbff33316927771927b4de10a5b\">metabolic</span> disturbances that can damage the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FQletZC3iaHbsGYx1NOg1746455778.mp3", "video": ""}, {"text": "A 72-year-old patient presents with sudden vision loss in one eye, severe headache, scalp tenderness, and jaw claudication. Fundoscopic examination reveals a pale, swollen optic disc with haemorrhages. Laboratory tests show elevated ESR and CRP levels. What is the diagnosis and the appropriate management?", "options": [{"label": "A", "text": "Arteritic AION; Lifestyle modifications", "correct": false}, {"label": "B", "text": "Non-arteritic AION; Lifestyle modifications", "correct": false}, {"label": "C", "text": "Arteritic AION; High dose corticosteroids", "correct": true}, {"label": "D", "text": "Non-arteritic AION; High dose corticosteroids", "correct": false}], "correct_answer": "C. Arteritic AION; High dose corticosteroids", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pNybXAxIXxvTJyEaNybV1743131948.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Arteritic AION (AAION)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Arteritic AION (NAION)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inflammation and potential <span class=\"customMeta\" data-dictid=\"40d68b98721692777183c42090e023\">blood clot</span> formation due to <strong>Giant Cell Arteritis (GCA)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> process; unclear reason for <span class=\"customMeta\" data-dictid=\"72c06d2cc71692777183b1cbaf5bae\">blood vessel</span> blockage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prevalence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>5-10% of AION cases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>90-95% of AION cases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Typical Age</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Around 70 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Middle-aged to older adults (usually over 50)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Age &gt; 50</li>\n<li>Northern European descent</li>\n<li>Other <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> diseases</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diabetes</li>\n<li>Hypertension</li>\n<li>Atherosclerosis</li>\n<li>Crowded <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Severe headache</strong></p>\n<p><strong>Scalp tenderness</strong></p>\n<p><strong>Jaw claudication</strong></p>\n<p>Systemic symptoms like fever and fatigue</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sudden vision loss (painless)</strong></p>\n<p>Altitudinal field defect</p>\n<p>Relative Afferent Pupillary <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">Defect</span> (RAPD)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ophthalmoscopic Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pale and swollen <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</li>\n<li>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots</li>\n<li>Splinter haemorrhages</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Swollen and hyperemic <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Field Defect</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inferior altitudinal defects are common</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnostic Tests</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Elevated ESR and CRP</li>\n<li>Temporal <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> biopsy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fluorescein angiography</li>\n<li>Visual field testing</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>High-dose corticosteroids</strong></li>\n<li>Long-term low-dose corticosteroids</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>No proven treatment</li>\n<li>Manage risk factors through<strong> lifestyle modifications</strong></li>\n<li>Low-dose <span class=\"customMeta\" data-dictid=\"deba671f4716927771828c95a320e5\">aspirin</span> (can be used sometimes)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZZohbLYE2dS1pratIYlI1747898145.mp3", "video": ""}, {"text": "A 48-year-old woman presents with a history of decreased vision in her right eye. On examining the right eye, there is RAPD, pain on eye elevation, and the fundus is normal. What is the most appropriate management?", "options": [{"label": "A", "text": "Conservative management", "correct": false}, {"label": "B", "text": "High-dose Corticosteroids", "correct": true}, {"label": "C", "text": "Oral antibiotics", "correct": false}, {"label": "D", "text": "Surgical intervention", "correct": false}], "correct_answer": "B. High-dose Corticosteroids", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> neuritis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conservative management</strong></p>\n<p>(Observation and Monitoring)</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mild symptoms</li>\n<li>Known history of similar episodes</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Many cases improve spontaneously.</li>\n<li>Suitable for mild symptoms but not recommended for severe cases or first episodes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>High-Dose Corticosteroids</strong></p>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Severe vision loss</li>\n<li>No history of previous episodes</li>\n<li>MRI evidence of demyelination</li>\n</ul>\n</td>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Intravenous <span class=\"customMeta\" data-dictid=\"c3adf9f403169277719294351e8fb8\">methylprednisolone</span> (1 g daily for 3 days) followed by oral <span class=\"customMeta\" data-dictid=\"2d5e8899351692777196bdf7ced01d\">prednisolone</span> taper</strong> as established by the <strong>ONTT trial </strong>(Optic <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> Treatment Trial).</li>\n<li>It accelerates visual recovery but does not prevent future <span class=\"customMeta\" data-dictid=\"eaea4028bf169277719371bd2eac9f\">multiple sclerosis</span> episodes. Patients with <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> when related to MS can also be given Glatiramer <span class=\"customMeta\" data-dictid=\"47765053a81692777180738f50cd4e\">acetate</span> and Beta Interferon 1a.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old woman presents with a 3-week history of difficulty in vision in her left eye, along with persistent headaches and occasional eye pain. She also reports trouble with colour perception. Fundoscopic examination reveals the findings shown in the image. Which type of optic neuritis is most likely to be seen?", "options": [{"label": "A", "text": "Papillitis", "correct": false}, {"label": "B", "text": "Retrobulbar neuritis", "correct": false}, {"label": "C", "text": "Neuroretinitis", "correct": true}, {"label": "D", "text": "Papilledema", "correct": false}], "correct_answer": "C. Neuroretinitis", "question_images": ["https://image.prepladder.com/notes/ecoGvTPllgrzfqN6fcmR1743131668.png"], "explanation_images": ["https://image.prepladder.com/notes/0x6ornXk2hqDY5I32VgU1743131742.png", "https://image.prepladder.com/notes/ecoGvTPllgrzfqN6fcmR1743131668.png", "https://image.prepladder.com/notes/05cI7sN28nrlqaFLONQP1743131856.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:745px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Papillitis </strong></p>\n<p style=\"text-align: center;\"><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Retrobulbar <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> </strong></p>\n<p style=\"text-align: center;\"><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Neuroretinitis</strong></p>\n<p style=\"text-align: center;\"><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Site </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic disc</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic nerve behind the eyeball.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic disc and surrounding <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> in the <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> area.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristic features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fundoscopy reveals a blurred disc margin due to leakage and increased <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> permeability, edematous and hyperaemic disc, and <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> cup is obliterated.</p>\n<p style=\"text-align:center\"><img alt=\"Papillitis\" data-author=\"Rui Zhang, Jiang Qian, Jie Guo, Yifei Yuan, Kang Xue, Han Yue, Ling Chen\" data-hash=\"4211\" data-license=\"CC BY 4.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1155/2016/2797028\" data-tags=\"March2025\" height=\"381\" src=\"https://image.prepladder.com/notes/0x6ornXk2hqDY5I32VgU1743131742.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pain on eye elevation</li>\n<li>RAPD (relative <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> pupillary defect) is observed.</li>\n</ul>\n<ul>\n<li>Fundoscopic examination typically reveals <strong>normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</strong>, at least initially, which is why the classic phrase, “<em>the patient sees nothing, and the doctor sees nothing</em>” is often used to describe <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> neuritis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> star is seen in fundoscopy (accumulation of lipids).</p>\n\t\t\t \n\n\t\t\t<p style=\"text-align:center\"><img alt=\"Macular star\" data-author=\"Viswanath Gajula, Ravi Kamepalli, Jagadeesh K. Kalavakunta\" data-hash=\"4210\" data-license=\"CC BY NC 3.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1002/ccr3.43\" data-tags=\"March2025\" height=\"402\" src=\"https://image.prepladder.com/notes/ecoGvTPllgrzfqN6fcmR1743131668.png\" width=\"500\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/91xJVE4C2PTlqeew0hHU1747896945.mp3", "video": ""}, {"text": "A 34-year-old woman has a 6-month history of worsening vision and difficulty with detailed tasks, along with occasional eye pain in her left eye. Fundoscopy shows a chalky white optic disc with normal vessels in her left eye. What is the most common cause of these findings?", "options": [{"label": "A", "text": "Papilledema", "correct": false}, {"label": "B", "text": "Multiple sclerosis", "correct": true}, {"label": "C", "text": "Retinitis pigmentosa", "correct": false}, {"label": "D", "text": "Glaucoma", "correct": false}], "correct_answer": "B. Multiple sclerosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/z6KJcvvW0ejYph1ItqDE1743131175.png", "https://image.prepladder.com/notes/EGfpidddMbWuiw0m22Kf1743131253.png", "https://image.prepladder.com/notes/lGLRyjFHxZYd6NM9uCJ01743131319.png", "https://image.prepladder.com/notes/JQeO7hZDIbwiAd3RnoZ71743131440.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:768px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Secondary </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Consecutive </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Glaucomatous </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Refers to the <span class=\"customMeta\" data-dictid=\"df4f1758e2169277718697ae66f3dd\">degeneration</span> of the nerve fibres</li>\n<li>Seen in the retrolaminar area.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Occurs following any <span class=\"customMeta\" data-dictid=\"e32252a2c41692777194fe542b3e35\">pathologic</span> condition or disease.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Occurs following destruction of <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">ganglion</span> cells secondary to lesions of the <span class=\"customMeta\" data-dictid=\"87b317afbd16927771844e0e534940\">choroid</span> and/ or retina</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Occurs due to long-standing glaucoma.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Multiple <span class=\"customMeta\" data-dictid=\"dae4dea0581692777198fdef9fa684\">sclerosis</span> <strong>(Option B)</strong></li>\n<li>Retrobulbar neuritis</li>\n<li>Leber's <span class=\"customMeta\" data-dictid=\"ee5175c06116927771880846d1cbe0\">hereditary</span> <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> atrophies</li>\n<li>Intracranial tumours (e.g. <span class=\"customMeta\" data-dictid=\"b775f0c475169277719593c573f6ff\">pituitary</span> tumours)</li>\n<li>Traumatic severance or <span class=\"customMeta\" data-dictid=\"954dd74f031692777182664659765f\">avulsion</span> of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve</li>\n<li>Toxic <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">amblyopia</span> (chronic <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> neuritis)</li>\n<li>Tabes dorsalis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long-standing <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve disease.</li>\n<li>Papilledema <strong>(Option A)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diffuse chorioretinitis</li>\n<li>Retinal <span class=\"customMeta\" data-dictid=\"45d1f54a631692777195670b446c7e\">pigmentary</span> dystrophies (e.g., <span class=\"customMeta\" data-dictid=\"4f1a033cae1692777197a3a6937a0c\">retinitis</span> pigmentosa <strong>(Option C)</strong>, <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> and <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> of the central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> artery)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glaucoma</p>\n<p><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fundoscopy </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chalky white</li>\n<li>Clear disc margin</li>\n<li>Lamina cribrosa well seen</li>\n<li>Normal vessels.</li>\n</ul>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Dirty grey</li>\n<li>Clear disc margin</li>\n<li>Lamina cribrosa obscured</li>\n<li>Peripapillary sheathing over vessels</li>\n<li>Hyaline bodies on the retina.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Waxy pallor</li>\n<li>Blurred disc margin</li>\n<li>Lamina cribrosa well seen</li>\n<li>Attenuated vessels</li>\n</ul>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Characterized by deep and wide <span class=\"customMeta\" data-dictid=\"4d57ccd00f1692777185c371df0426\">cupping</span> of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc and <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> shift of the blood vessels.</p>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Primary optic atrophy\" data-author=\"Sean Collol, James Gilman\" data-hash=\"4206\" data-license=\"NA\" data-source=\"https://morancore.utah.edu/basic-ophthalmology-review/optic-atrophy/\" data-tags=\"March2025\" height=\"415\" src=\"https://image.prepladder.com/notes/z6KJcvvW0ejYph1ItqDE1743131175.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Secondary optic atrophy\" data-author=\"Sean Collol, James Gilman\" data-hash=\"4207\" data-license=\"NA\" data-source=\"https://morancore.utah.edu/basic-ophthalmology-review/optic-atrophy/\" data-tags=\"March2025\" height=\"499\" src=\"https://image.prepladder.com/notes/EGfpidddMbWuiw0m22Kf1743131253.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Consecutive optic atrophy\" data-author=\"V. Osaguona\" data-hash=\"4208\" data-license=\"NA\" data-source=\"https://www.semanticscholar.org/paper/Differential-diagnoses-of-the-pale-white-atrophic-Osaguona/9ef64b2cbe3b7e8541a3deede266744dd069bf04\" data-tags=\"March2025\" height=\"341\" src=\"https://image.prepladder.com/notes/lGLRyjFHxZYd6NM9uCJ01743131319.png\" width=\"500\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Glaucomatous optic atrophy\" data-author=\"Sean Collol, James Gilman\" data-hash=\"4209\" data-license=\"NA\" data-source=\"https://morancore.utah.edu/basic-ophthalmology-review/optic-atrophy/\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/JQeO7hZDIbwiAd3RnoZ71743131440.png\" width=\"500\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TK1Su4TfzUvmnRMiAtZg1747896625.mp3", "video": ""}, {"text": "A 45-year-old female reports a gradual decline in vision in her right eye over the past three months, accompanied by blurry vision and impaired colour perception in that eye. Upon examination, the ophthalmologist suspected optic nerve damage and advised further tests. Which of the following manifestations does not indicate optic nerve dysfunction?", "options": [{"label": "A", "text": "Positive scotoma", "correct": true}, {"label": "B", "text": "Dyschromatopsia", "correct": false}, {"label": "C", "text": "Central scotoma", "correct": false}, {"label": "D", "text": "Decrease in contrast sensitivity", "correct": false}], "correct_answer": "A. Positive scotoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/vNAIyErKnWZnNi0SGrMF1743130970.png", "https://image.prepladder.com/notes/usTLQ7GEj89IFyhsQxFu1743131015.png", "https://image.prepladder.com/notes/7bWFQjrv9nUiTMEuhQNa1743131056.png", "https://image.prepladder.com/notes/XM9cKLlF9S1O86u17EVc1743131100.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:554px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Central <span class=\"customMeta\" data-dictid=\"a685fb1a5716927771982efa29a365\">scotoma</span> (most common) </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Central scotoma\" data-author=\"NA\" data-hash=\"4203\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/usTLQ7GEj89IFyhsQxFu1743131015.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Centrocecal scotoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Centrocecal scotoma\" data-author=\"NA\" data-hash=\"4204\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/7bWFQjrv9nUiTMEuhQNa1743131056.png\" width=\"500\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Altitudinal field defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Altitudinal field defect\" data-author=\"NA\" data-hash=\"4205\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/XM9cKLlF9S1O86u17EVc1743131100.png\" width=\"500\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ehgzwCz7glpQzwYMXjfE1748249029.mp3", "video": ""}, {"text": "Which of the following arteries contributes to the formation of the Circle of Zinn-Haller?", "options": [{"label": "A", "text": "Central retinal artery", "correct": false}, {"label": "B", "text": "Ophthalmic artery", "correct": false}, {"label": "C", "text": "Short posterior ciliary arteries", "correct": true}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "C. Short posterior ciliary arteries", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/UqSzREbutE6UWLjDb0JU1743130817.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1oMVAZ51zKLfeH93AOqD1747894921.mp3", "video": ""}, {"text": "A 62-year-old patient presents with a visual field defect following a stroke. Neuroimaging reveals a lesion in the occipital lobe related to the territory of the posterior cerebral artery affecting the calcarine cortex. Which of the following visual field characteristics is most likely associated with this type of lesion?", "options": [{"label": "A", "text": "Congruous Homonymous Hemianopia with Macular Sparing", "correct": true}, {"label": "B", "text": "Congruous Homonymous Hemianopia without Macular Sparing", "correct": false}, {"label": "C", "text": "Incongruous homonymous hemianopia with Macular sparing", "correct": false}, {"label": "D", "text": "Incongruous homonymous hemianopia without Macular sparing", "correct": false}], "correct_answer": "A. Congruous Homonymous Hemianopia with Macular Sparing", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/0frGXAIi3RSElxlRY0dD1743129605.png", "https://image.prepladder.com/notes/8J71WTRSRFfnkov2Ufmo1743130695.png", "https://image.prepladder.com/notes/co4YxQ2ymMx4MAfUyE181743687227.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Nf7JQof9VXLbhEI6IOan1747894603.mp3", "video": ""}, {"text": "A 58-year-old patient presents with visual disturbances. Neuroimaging reveals a lesion in the temporal lobe affecting the inferior optic radiations. Which visual field defects are most likely associated with this finding?", "options": [{"label": "A", "text": "Inferior homonymous quadrantanopia", "correct": false}, {"label": "B", "text": "Superior homonymous quadrantanopia", "correct": true}, {"label": "C", "text": "Central scotoma", "correct": false}, {"label": "D", "text": "Homonymous hemianopia", "correct": false}], "correct_answer": "B. Superior homonymous quadrantanopia", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/t96noqQEPK4eCqRre0xu1743130371.png", "https://image.prepladder.com/notes/JkE6h15DdHnQLKYIO9rB1743130120.png", "https://image.prepladder.com/notes/E8kaayVBZEbhP81XbJR31743130488.png", "https://image.prepladder.com/notes/jB3KWFxgzsqhOlvpEClL1743130534.png", "https://image.prepladder.com/notes/0frGXAIi3RSElxlRY0dD1743129605.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiations</strong></p>\n<p><strong>(Meyer’s Loop)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiations</strong></p>\n<p><strong>(Baum’s Loop)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Temporal <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parietal lobe</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Affected Visual Field</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior quadrants of the <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> of both eyes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inferior quadrants of the <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> of both eyes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> quadrantanopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> <span class=\"customMeta\" data-dictid=\"e0b79d0fde16927771965173ff3031\">quadrantanopia</span> </strong><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Associated Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Memory loss</li>\n<li>Hearing loss</li>\n<li>Auditory hallucinations</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contralateral hemiplegia</li>\n<li>Hemianesthesia</li>\n<li>Optokinetic nystagmus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\" pie in the sky\" data-author=\"NA\" data-hash=\"4194\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/JkE6h15DdHnQLKYIO9rB1743130120.png\" width=\"500\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Pie on the floor output\" data-author=\"NA\" data-hash=\"4196\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"320\" src=\"https://image.prepladder.com/notes/E8kaayVBZEbhP81XbJR31743130488.png\" width=\"500\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2PD8w4MUV10YMP7WpgYq1747893721.mp3", "video": ""}, {"text": "A 58-year-old patient presents with right-sided visual field loss in both eyes, resulting in a homonymous hemianopic defect. Neuroimaging and clinical examination suggest a lesion affecting the visual pathway. Based on the above findings, which anatomical location is most likely implicated in this patient's condition?", "options": [{"label": "A", "text": "Right optic tract", "correct": false}, {"label": "B", "text": "Left optic tract", "correct": true}, {"label": "C", "text": "Right optic nerve", "correct": false}, {"label": "D", "text": "Optic chiasma", "correct": false}], "correct_answer": "B. Left optic tract", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/eq5AIMaZYYAOI7K6qs3i1743129347.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:573px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location of the <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristic features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic nerve</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Marked loss of vision or complete <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> on the affected side associated.</li>\n<li>Near (accommodation) <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is present.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic chiasma</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Bitemporal hemianopia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic tract</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contralateral <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> hemianopia</li>\n<li>Contralateral hemianopic pupillary responses, i.e. Wernicke's reaction.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic radiations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Superior quadrantic <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">hemianopia</span> (pie in the sky)\n\t\t\t\t<ul>\n<li>Produced when the <strong>inferior </strong>fibres (Meyer’s loop) are involved in <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> lesions)</li>\n</ul>\n</li>\n<li>Inferior quadrantic <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">hemianopia</span> (pie on the floor)\n\t\t\t\t<ul>\n<li>Produced when <strong>superior </strong>fibres (Baum’s loop) are involved in <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> lesions.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Visual cortex</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Homonymous hemianopia, often with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> sparing</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JYezccIfz06lzjWmu63s1745224546.mp3", "video": ""}, {"text": "A 64-year-old patient presents with difficulty seeing objects. MRI findings reveal a pituitary adenoma causing compression at the optic chiasma. Which visual field defect is most likely associated with this condition?", "options": [{"label": "A", "text": "No options available", "correct": true}], "correct_answer": "A. No options available", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/3SjOWCKiWtiGgRuU5Ury1743129470.png", "https://image.prepladder.com/notes/rhxe9cjz5FrKRuhXnyMB1747944324.png", "https://image.prepladder.com/notes/475PyWODlHb1bh0szWR41743129664.png", "https://image.prepladder.com/notes/BbGiSl040JK03GetGyL21743129916.png", "https://image.prepladder.com/notes/JkE6h15DdHnQLKYIO9rB1743130120.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Pathway Lesions and Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Site of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fibers Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Field Defect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> + <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Anopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bilateral <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Visual_field_bitemporal_hemianopia\" data-author=\"NA\" data-hash=\"4189\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"492\" src=\"https://image.prepladder.com/notes/3SjOWCKiWtiGgRuU5Ury1743129470.png\" width=\"500\"/>\n<p><strong>Bitemporal Hemianopia</strong></p>\n<p><strong>(Heteronymous Hemianopia)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Optic Tract</strong></li>\n<li><strong>Lateral Geniculate Body (LGB Lesion)</strong></li>\n<li><strong>Optic Radiation</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + Contralateral <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Homonymous Hemianopia\" data-author=\"\" data-hash=\"13221\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/rhxe9cjz5FrKRuhXnyMB1747944324.png\"/>\n<p><strong>Homonymous Hemianopia</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Cortex without the involvement of tip</strong></p>\n<p><strong>(Post. Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + Contralateral <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers except <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> representation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\" Homonymous Hemianopia with macular sparing\" data-author=\"NA\" data-hash=\"4192\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/475PyWODlHb1bh0szWR41743129664.png\" width=\"500\"/></p>\n<p><strong>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> Sparing</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tip of Visual Cortex</strong></p>\n<p><strong>(Middle Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Macular Representation of Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> and Contralateral <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"Macular Homonymous Hemianopia\" data-author=\"NA\" data-hash=\"4193\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" height=\"500\" src=\"https://image.prepladder.com/notes/BbGiSl040JK03GetGyL21743129916.png\" width=\"500\"/>\n<p><strong>Macular Homonymous Hemianopia</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HTXBCCnc7ociaul4T1Gk1747893433.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 36 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "What is the likely reason for a patient showing both unilateral and bilateral abducent palsy?", "options": [{"label": "A", "text": "Retinoblastoma", "correct": false}, {"label": "B", "text": "Orbital pseudotumor", "correct": false}, {"label": "C", "text": "Orbital cellulitis", "correct": false}, {"label": "D", "text": "Cavernous sinus thrombosis", "correct": true}], "correct_answer": "D. Cavernous sinus thrombosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/VVMU0UtNaNtYyRxXtJjI1746444695.png", "https://image.prepladder.com/notes/n6tSWPMuKZkYk8Zvoj381746444762.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Abducens Nerve (cranial nerve VI)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Motor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Origin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pons (lower border, opposite the <span class=\"customMeta\" data-dictid=\"70469583201692777196a8f1c66bfc\">pyramid</span> of the medulla).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Course </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><img alt=\"ANA246\" data-author=\"\" data-hash=\"11982\" data-license=\"\" data-source=\"\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/VVMU0UtNaNtYyRxXtJjI1746444695.png\"/></p>\n<p><img alt=\"POP084\" data-author=\"\" data-hash=\"11983\" data-license=\"\" data-source=\"\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/n6tSWPMuKZkYk8Zvoj381746444762.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Functional component</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>General <span class=\"customMeta\" data-dictid=\"3db910d8571692777198303e3bcb27\">somatic</span> <span class=\"customMeta\" data-dictid=\"8833ce72c71692777187014d5585e7\">efferent</span> fibres</strong>: Arise from the <strong>abducent nucleu</strong>s in the <span class=\"customMeta\" data-dictid=\"5e4684038e16927771967a14f73f37\">pons</span> and supply the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle of the eyeball.</li>\n<li><strong>General <span class=\"customMeta\" data-dictid=\"3db910d8571692777198303e3bcb27\">somatic</span> <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> </strong>fibres carry <span class=\"customMeta\" data-dictid=\"cd38f5515716927771969b9fb17e95\">proprioceptive</span> sensations from the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> and terminate in the <span class=\"customMeta\" data-dictid=\"722dfab4551692777192ec9f24aedf\">mesencephalic</span> <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> of the <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Supply </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle of the eyeball</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical aspect </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> <span class=\"customMeta\" data-dictid=\"3e745919391692777200fae21b7251\">thrombosis</span> leads to <span class=\"customMeta\" data-dictid=\"493415137f1692777180adce8b5447\">abducens</span> nerve palsy</li>\n<li>Lesion or injury (elevated <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure) of the <span class=\"customMeta\" data-dictid=\"493415137f1692777180adce8b5447\">abducens</span> nerve results in <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> of the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, leading to:\n\t\t\t\t<ul>\n<li>Inability to <span class=\"customMeta\" data-dictid=\"cc4da2fb151692777180dc699ae203\">abduct</span> the eye</li>\n<li>Diplopia (double vision)</li>\n<li>Convergent <span class=\"customMeta\" data-dictid=\"4d366430b5169277719914874d78a5\">squint</span> (due to the unopposed action of <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> rectus)</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which structures are affected in a pregnant woman who exhibits fever, retroorbital pain, headache, pulsatile proptosis of the right eye, and tinnitus, while having normal blood pressure and fundus? 1. Abducens nerve 2. Oculomotor nerve 3. Internal carotid artery 4. Cavernous sinus", "options": [{"label": "A", "text": "A, B, C", "correct": false}, {"label": "B", "text": "B, C ,D", "correct": false}, {"label": "C", "text": "A, C ,D", "correct": false}, {"label": "D", "text": "A, B, C, D", "correct": true}], "correct_answer": "D. A, B, C, D", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which cranial nerves does the oculocephalic reflex evaluate? A. III B. IV C. VI D. VIII E. VII", "options": [{"label": "A", "text": "A and C", "correct": false}, {"label": "B", "text": "A and E", "correct": false}, {"label": "C", "text": "A and D", "correct": false}, {"label": "D", "text": "A, C and D", "correct": true}], "correct_answer": "D. A, C and D", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/XhXxh6KslFr0vwf7wpDy1746706719.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What would be the next investigative step for a 27-year-old female patient who presents with sudden vision loss accompanied by a relative afferent pupillary defect in her right eye, while her left eye appears normal on examination? 1. MRI brain &amp;amp; orbit 2. Myelin oligodendrocyte glycoprotein (MOG) and neuromyelitis optica (NMO) antibodies 3. Blood sugar 4. Thyroid profile", "options": [{"label": "A", "text": "1, 2 and 3", "correct": true}, {"label": "B", "text": "1 and 2", "correct": false}, {"label": "C", "text": "2 and 3", "correct": false}, {"label": "D", "text": "3 and 4", "correct": false}], "correct_answer": "A. 1, 2 and 3", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a man of 45 years who arrives at the emergency department with an abrupt loss of vision and experiencing painful movements of the eye? Upon examination, a relative afferent pupillary defect is observed in the affected eye. Further visual field testing demonstrates a central scotoma in the same eye.", "options": [{"label": "A", "text": "Optic nerve glioma", "correct": false}, {"label": "B", "text": "Optic neuritis", "correct": true}, {"label": "C", "text": "Eale’s disease", "correct": false}, {"label": "D", "text": "Neuroretinitis", "correct": false}], "correct_answer": "B. Optic neuritis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/D46DunGQaYKVort2Jmpu1745924614.png", "https://image.prepladder.com/content/5RSgX788fOfAyGp2kwF51745924624.png", "https://image.prepladder.com/content/HG1XGuFaK7HdD5p9MsQ91745924636.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:678px\">\n<tbody>\n<tr>\n<td colspan=\"6\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Classification of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> neuritis:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Papillitis </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Retrobulbar <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Neuroretinitis (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Site </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic disc</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic nerve behind the eyeball.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic disc and surrounding <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> in the <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> area.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Characteristic features</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Fundoscopy reveals a blurred disc margin due to leakage and increased <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> permeability, edematous and hyperaemic disc, and <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> cup is obliterated.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Rui Zhang, Jiang Qian, Jie Guo, Yifei Yuan, Kang Xue, Han Yue, Ling Chen\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1155/2016/2797028\" data-tags=\"\" height=\"204\" src=\"https://image.prepladder.com/content/D46DunGQaYKVort2Jmpu1745924614.png\" width=\"267\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pain on eye elevation</li>\n<li><strong>RAPD (relative <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> pupillary defect)</strong> is observed.</li>\n<li>Fundoscopic examination typically reveals normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc, at least initially, which is why the classic phrase, “the patient sees nothing, and the doctor sees nothing” is often used to describe <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> neuritis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A <strong>macular star</strong> is seen in fundoscopy (accumulation of lipids).</li>\n<li><strong>Optic atrophy</strong> present</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Viswanath Gajula, Ravi Kamepalli, Jagadeesh K. Kalavakunta\" data-hash=\"\" data-license=\"CC BY NC 3.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1002/ccr3.43\" data-tags=\"\" height=\"206\" src=\"https://image.prepladder.com/content/5RSgX788fOfAyGp2kwF51745924624.png\" width=\"270\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td colspan=\"5\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Visual loss: <strong>Monocular sudden, progressive and profound visual loss</strong> is the hallmark of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li>Dark <span class=\"customMeta\" data-dictid=\"c623a72bdd16927771808d60122016\">adaptation</span> may be lowered.</li>\n<li>Visual obscuration in bright light is a typical symptom of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li>Impairment of <span class=\"customMeta\" data-dictid=\"c82cc1010816927771859bbfde816b\">color vision</span> is always present in <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li><strong>Uhthoff's symptom: </strong>Episodic <span class=\"customMeta\" data-dictid=\"a6cf2c3dc51692777200ef7fb22f69\">transient</span> obscuration of vision on exertion and on exposure to heat, which recovers on resting or moving away from the heat, occurs in patients with isolated <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li><strong>Pulfrich's phenomenon:</strong> Depth perception may be impaired, particularly for the moving object.</li>\n<li>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> is usually <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> markedly.</li>\n<li>Visual field changes: The most common field <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> is a relative central or <span class=\"customMeta\" data-dictid=\"fd318be9d4169277718460949f7037\">centrocecal</span> scotoma.</li>\n<li>Contrast sensitivity is impaired.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"6\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> neuritis:</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conservative management</strong></p>\n<p>(Observation and Monitoring)</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mild symptoms</li>\n<li>Known history of similar episodes</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Many cases improve spontaneously.</li>\n<li>Suitable for mild symptoms but not recommended for severe cases or first episodes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>High-Dose Corticosteroids</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Severe vision loss</li>\n<li>No history of previous episodes</li>\n<li>MRI evidence of demyelination</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Intravenous <span class=\"customMeta\" data-dictid=\"c3adf9f403169277719294351e8fb8\">methylprednisolone</span> (1 g daily for 3 days) followed by oral <span class=\"customMeta\" data-dictid=\"2d5e8899351692777196bdf7ced01d\">prednisolone</span> taper as established by the ONTT trial (Optic <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> Treatment Trial).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a man of 45 years who arrives at the emergency department with an abrupt loss of vision and experiencing painful movements of the eye? Upon examination, a relative afferent pupillary defect is observed in the affected eye. Further visual field testing demonstrates a central scotoma in the same eye.", "options": [{"label": "A", "text": "Optic nerve glioma", "correct": false}, {"label": "B", "text": "Optic neuritis", "correct": true}, {"label": "C", "text": "Eale’s disease", "correct": false}, {"label": "D", "text": "Neuroretinitis", "correct": false}], "correct_answer": "B. Optic neuritis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/toqTtID3hNwMtocFl3TZ1746096588.png", "https://image.prepladder.com/content/eCNW1rfATWJBuPpnWiVn1746096588.png", "https://image.prepladder.com/content/dd86kU1AP9gY0sAMgiS81747905662.png", "https://image.prepladder.com/content/foI8CwDQRTiVDg14T7p71747905655.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:678px\">\n<tbody>\n<tr>\n<td colspan=\"6\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Classification of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> neuritis:</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Papillitis </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Retrobulbar <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Neuroretinitis (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Site </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic disc</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic nerve behind the eyeball.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic disc and surrounding <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> in the <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> area.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Characteristic features</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Fundoscopy reveals a blurred disc margin due to leakage and increased <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> permeability, edematous and hyperaemic disc, and <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> cup is obliterated.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Rui Zhang, Jiang Qian, Jie Guo, Yifei Yuan, Kang Xue, Han Yue, Ling Chen\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1155/2016/2797028\" data-tags=\"\" height=\"196\" src=\"https://image.prepladder.com/content/toqTtID3hNwMtocFl3TZ1746096588.png\" width=\"256\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pain on eye elevation</li>\n<li><strong>RAPD (relative <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> pupillary defect)</strong> is observed.</li>\n<li>Fundoscopic examination typically reveals normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc, at least initially, which is why the classic phrase, “the patient sees nothing, and the doctor sees nothing” is often used to describe <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> neuritis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A <strong>macular star</strong> is seen in fundoscopy (accumulation of lipids).</li>\n<li><strong>Optic atrophy</strong> present</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Viswanath Gajula, Ravi Kamepalli, Jagadeesh K. Kalavakunta\" data-hash=\"\" data-license=\"CC BY NC 3.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1002/ccr3.43\" data-tags=\"\" height=\"214\" src=\"https://image.prepladder.com/content/eCNW1rfATWJBuPpnWiVn1746096588.png\" width=\"267\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td colspan=\"5\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Visual loss: <strong>Monocular sudden, progressive and profound visual loss</strong> is the hallmark of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li>Dark <span class=\"customMeta\" data-dictid=\"c623a72bdd16927771808d60122016\">adaptation</span> may be lowered.</li>\n<li>Visual obscuration in bright light is a typical symptom of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li>Impairment of <span class=\"customMeta\" data-dictid=\"c82cc1010816927771859bbfde816b\">color vision</span> is always present in <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li><strong>Uhthoff's symptom: </strong>Episodic <span class=\"customMeta\" data-dictid=\"a6cf2c3dc51692777200ef7fb22f69\">transient</span> obscuration of vision on exertion and on exposure to heat, which recovers on resting or moving away from the heat, occurs in patients with isolated <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuritis.</li>\n<li><strong>Pulfrich's phenomenon:</strong> Depth perception may be impaired, particularly for the moving object.</li>\n<li>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> is usually <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> markedly.</li>\n<li>Visual field changes: The most common field <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> is a relative central or <span class=\"customMeta\" data-dictid=\"fd318be9d4169277718460949f7037\">centrocecal</span> scotoma.</li>\n<li>Contrast sensitivity is impaired.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"6\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> neuritis:</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conservative management</strong></p>\n<p>(Observation and Monitoring)</p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mild symptoms</li>\n<li>Known history of similar episodes</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Many cases improve spontaneously.</li>\n<li>Suitable for mild symptoms but not recommended for severe cases or first episodes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>High-Dose Corticosteroids</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Severe vision loss</li>\n<li>No history of previous episodes</li>\n<li>MRI evidence of demyelination</li>\n</ul>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Intravenous <span class=\"customMeta\" data-dictid=\"c3adf9f403169277719294351e8fb8\">methylprednisolone</span> (1 g daily for 3 days) followed by oral <span class=\"customMeta\" data-dictid=\"2d5e8899351692777196bdf7ced01d\">prednisolone</span> taper as established by the ONTT trial (Optic <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> Treatment Trial).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a patient diagnosed with a stroke, their visual field testing indicated macula sparing homonymous hemianopia. Where is the probable location of the lesion within the optic pathway?", "options": [{"label": "A", "text": "Optic tract", "correct": false}, {"label": "B", "text": "Occipital lobe", "correct": true}, {"label": "C", "text": "Optic radiation", "correct": false}, {"label": "D", "text": "Optic chiasma", "correct": false}], "correct_answer": "B. Occipital lobe", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/WAmpxGw2UN2AjdZZpjlr1746104161.png", "https://image.prepladder.com/content/KrPfXRSpXu1Bf1V6xOx61746104161.png", "https://image.prepladder.com/content/VkNgNzo5DSveHmTd2JFT1746104161.png", "https://image.prepladder.com/content/G8vscMwmc70afTFbUeoA1746104161.png", "https://image.prepladder.com/content/JSyRjIvfP5sh19HcQeO41746104161.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Visual Pathway Lesions and Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Site of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fibers Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Field Defect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> + Nasal Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"300\" src=\"https://image.prepladder.com/content/WAmpxGw2UN2AjdZZpjlr1746104161.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Anopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Chiasma (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral Nasal Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"297\" src=\"https://image.prepladder.com/content/KrPfXRSpXu1Bf1V6xOx61746104161.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Bitemporal Hemianopia</strong></p>\n<p style=\"text-align:center\"><strong>(Heteronymous Hemianopia)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Tract/ <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> Geniculate Body (LGB)/ Optic Radiation (Option A) (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + Contralateral Nasal Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"300\" src=\"https://image.prepladder.com/content/VkNgNzo5DSveHmTd2JFT1746104161.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Homonymous Hemianopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">Cortex</span> without the involvement of tip</strong></p>\n<p><strong>(Posterior Cerebral Artery) (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + Contralateral Nasal Fibers except <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> representation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"300\" src=\"https://image.prepladder.com/content/G8vscMwmc70afTFbUeoA1746104161.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> Sparing</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tip of Visual Cortex</strong></p>\n<p><strong>(Middle Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Macular Representation of Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> and Contralateral Nasal Fibers.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"300\" src=\"https://image.prepladder.com/content/JSyRjIvfP5sh19HcQeO41746104161.png\" width=\"300\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Macular Homonymous Hemianopia</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a middle-aged man with diabetes, who has reported a decline in vision and whose fluorescein angiography displays the depicted image?", "options": [{"label": "A", "text": "Mild non proliferative diabetic retinopathy", "correct": false}, {"label": "B", "text": "Moderate non proliferative diabetic retinopathy", "correct": false}, {"label": "C", "text": "Severe non proliferative diabetic retinopathy", "correct": false}, {"label": "D", "text": "Proliferative diabetic retinopathy", "correct": true}], "correct_answer": "D. Proliferative diabetic retinopathy", "question_images": ["https://image.prepladder.com/content/KRQtAMtoNvwMD72YT24U1747905998.png"], "explanation_images": ["https://image.prepladder.com/content/TMcIWKXEQmoRR4wrVxjC1747906001.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:672px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Category </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">Retinopathy</span> (NPDR):</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>No <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in 12 months</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Very Mild NPDR:</strong></p>\n<p>Microaneurysms only</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review most patients in 12 months</p>\n<p>(Option D)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mild NPDR: (Option A)</strong></p>\n<p>Any or all of the: microaneurysms, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages, exudates, and <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, up to the level of moderate NPDR. No <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> anomalies (IRMA) or significant beading.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review range 6-12 months, depending on the severity of signs, stability, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> factors, and patient's circumstances</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Moderate NPDR: (Option B)</strong></p>\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages in 1-3 quadrants or mild IRMA</li>\n<li>Significant <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> can be present in no more than 1 quadrant</li>\n<li>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots commonly present</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in approximately 6 months</p>\n<p> </p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Severe NPDR: (Option C)</strong></p>\n<p>The 4-2-1 rule; is one or more of the:</p>\n<ul>\n<li>Severe hemorrhages in all 4 quadrants</li>\n<li>Significant <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> in 2 or more quadrants</li>\n<li>Moderate IRMA in 1 or more quadrants</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in 4 months</p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Very severe NPDR: </strong></p>\n<p>Two or more of the criteria for severe NPDR</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in 2-3 months</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">Retinopathy</span> (PDR): (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mild-moderate PDR: </strong></p>\n<p><strong>New vessels on the disc (NVD) or new vessels elsewhere (NVE)</strong>, but extent insufficient to meet the high-risk criteria</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Treatment is considered according to the severity of signs, stability, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> factors, and the patient's circumstances such as reliability of attendance for review. If not treated, review in up to 2 months</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>High-risk PDR: </strong></p>\n<ul>\n<li>NVD greater than ⅓ disc area</li>\n<li>Any NVD with <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> hemorrhage</li>\n<li>NVE greater than ½ disc area with <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> hemorrhage</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Treatment should be performed immediately when possible and certainly on the same day if <span class=\"customMeta\" data-dictid=\"509310d4411692777199f2ffdb7769\">symptomatic</span> presentation with a good <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> view</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Advanced <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> eye disease:</strong></p>\n<p>It is characterized by tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment. Significant persistent <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> and <span class=\"customMeta\" data-dictid=\"624c00049d1692777193b1a9d81379\">neovascular</span> glaucoma.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vitreoretinal surgery with photocoagulation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the site of the lesion.", "options": [{"label": "A", "text": "Right occipital lobe", "correct": false}, {"label": "B", "text": "Left occipital lobe", "correct": true}, {"label": "C", "text": "Right optic tract", "correct": false}, {"label": "D", "text": "Optic chiasma", "correct": false}], "correct_answer": "B. Left occipital lobe", "question_images": ["https://image.prepladder.com/notes/NT37fXUxefnrh6aRAmuh1747058753.png"], "explanation_images": ["https://image.prepladder.com/notes/NT37fXUxefnrh6aRAmuh1747058753.png", "https://image.prepladder.com/content/9vlKtKoyHlUdauQRXXiB1745576811.png", "https://image.prepladder.com/content/i1GWWEMXwS27Ec0lrOnJ1745576837.png", "https://image.prepladder.com/content/fgrKKSMIVS9lv3nGNSzz1745576837.png", "https://image.prepladder.com/content/5caWUYTDk2yXp6C6j9NU1745576837.png", "https://image.prepladder.com/content/LMN21GkRfU9PLfHw8ly01745576837.png", "https://image.prepladder.com/content/ZwHzorOTBU5gPyggFEsN1745576837.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Components of Visual Pathway</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Retina</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>First-order Neurons:</strong> <strong>Bipolar cells</strong> in the inner nuclear layer of the retina.</li>\n<li><strong>Second-order Neurons: Ganglion cells</strong> in the retina; their axons <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the <strong>optic nerve</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Carries visual information from the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> to the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> chiasm.</li>\n<li>Temporal and Nasal fibres of the same eye.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Partial <span class=\"customMeta\" data-dictid=\"3dfb76e26c16927771855c6df807b9\">decussation</span> occurs</li>\n<li>Nasal fibres cross to the opposite side, while <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> fibres remain ipsilateral.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Tract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Carries visual information from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"e2cc97dc331692777184dee1ae5678\">chiasma</span> to the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> Geniculate body (LGB).</li>\n<li>Temporal fibres of the same eye and Nasal fibres of the opposite eye.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lateral Geniculate Body (LGB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Third Order Neurons:</strong> Relay visual information to the visual cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Radiations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Meyer's Loop: </strong>Carries information from lower <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> quadrants to the <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> part of the visual cortex.</li>\n<li><strong>Baum’s Loop (Dorsal): </strong>Carries information from upper <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> quadrants to the superior part of the visual cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Occipital Cortex</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The primary visual <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> (V1), corresponding to <strong>Brodmann area 17</strong>, is situated on the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> side of the <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> lobe, particularly along the borders of the <span class=\"customMeta\" data-dictid=\"87c21c267916927771835c18842bb9\">calcarine</span> fissure.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Visual Pathway Lesions and Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Site of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fibers Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Field Defect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> + Nasal Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"200\" src=\"https://image.prepladder.com/content/i1GWWEMXwS27Ec0lrOnJ1745576837.png\" width=\"200\"/></p>\n<p>Anopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral Nasal Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"197\" src=\"https://image.prepladder.com/content/fgrKKSMIVS9lv3nGNSzz1745576837.png\" width=\"201\"/></p>\n<p>Bitemporal Hemianopia</p>\n<p>(Heteronymous Hemianopia) <strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Tract/ <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> Geniculate Body (LGB)/ <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + Contralateral Nasal Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"201\" src=\"https://image.prepladder.com/content/5caWUYTDk2yXp6C6j9NU1745576837.png\" width=\"201\"/></p>\n<p>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">Cortex</span> without the involvement of tip</strong></p>\n<p><strong>(Posterior Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + Contralateral Nasal Fibers except <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> representation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"201\" src=\"https://image.prepladder.com/content/LMN21GkRfU9PLfHw8ly01745576837.png\" width=\"201\"/>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> Sparing <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tip of Visual Cortex</strong></p>\n<p><strong>(Middle Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Macular Representation of <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">Ipsilateral</span> <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> and Contralateral Nasal Fibers.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"201\" src=\"https://image.prepladder.com/content/ZwHzorOTBU5gPyggFEsN1745576837.png\" width=\"201\"/></p>\n<p>Macular Homonymous Hemianopia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a patient, a 33-year-old female presents with symptoms of gradual vision loss specifically affecting the right halves of both eyes. The question pertains to the location of the lesion in the optic pathway.", "options": [{"label": "A", "text": "Left optic tract", "correct": true}, {"label": "B", "text": "Right visual cortex", "correct": false}, {"label": "C", "text": "Optic chiasma", "correct": false}, {"label": "D", "text": "Right optic nerve", "correct": false}], "correct_answer": "A. Left optic tract", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/XUEzEVgKjLH1aXEBN3q11745408814.png", "https://image.prepladder.com/content/m0M5fDKPCuNocNBqvwp61745408888.png", "https://image.prepladder.com/content/vco4NE3RLCRoGzjsnzAd1745408898.png", "https://image.prepladder.com/content/6wkip0hL9kZEp4T5x6o11745408903.png", "https://image.prepladder.com/content/DOUg9QEh17OdGadyL21x1745408911.png", "https://image.prepladder.com/content/hLPwF3BjCqyOuyQ8xrKN1745408918.png"], "explanation": "<p>Correct Answer A - Left &lt;span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\"&gt;optic&lt;/span&gt; tract</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Components of Visual Pathway</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Retina</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>First-order Neurons:</strong> <strong>Bipolar cells</strong> in the inner nuclear layer of the retina.</li>\n<li><strong>Second-order Neurons: <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">Ganglion</span> cells</strong> in the retina; their axons <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the <strong>optic nerve</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Carries visual information from the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> to the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> chiasm.</li>\n<li>Temporal and <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> fibres of the same eye.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Partial <span class=\"customMeta\" data-dictid=\"3dfb76e26c16927771855c6df807b9\">decussation</span> occurs</li>\n<li>Nasal fibres cross to the opposite side, while <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> fibres remain ipsilateral.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Tract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Carries visual information from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"e2cc97dc331692777184dee1ae5678\">chiasma</span> to the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> <span class=\"customMeta\" data-dictid=\"00b4dbe9e4169277718881a95f7864\">Geniculate</span> body (LGB).</li>\n<li>Temporal fibres of the same eye and <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> fibres of the opposite eye.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lateral <span class=\"customMeta\" data-dictid=\"00b4dbe9e4169277718881a95f7864\">Geniculate</span> Body (LGB)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Third Order Neurons:</strong> Relay visual information to the visual cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Radiations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Meyer's Loop: </strong>Carries information from lower <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> quadrants to the <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> part of the visual cortex.</li>\n<li><strong>Baum’s Loop (Dorsal): </strong>Carries information from upper <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> quadrants to the superior part of the visual cortex.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Occipital Cortex</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The primary visual <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">cortex</span> (V1), corresponding to <strong>Brodmann area 17</strong>, is situated on the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> side of the <span class=\"customMeta\" data-dictid=\"77dc7a0ab81692777194dba7ab78ab\">occipital</span> lobe, particularly along the borders of the <span class=\"customMeta\" data-dictid=\"87c21c267916927771835c18842bb9\">calcarine</span> fissure.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Visual <span class=\"customMeta\" data-dictid=\"3aa5abc2fa169277719488e088076d\">Pathway</span> Lesions and Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Site of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Fibers Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Field Defect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> + <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"> </p>\n<p style=\"text-align: center;\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"191\" src=\"https://image.prepladder.com/content/m0M5fDKPCuNocNBqvwp61745408888.png\" width=\"191\"/></p>\n<p style=\"text-align: center;\">Anopia <strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"202\" src=\"https://image.prepladder.com/content/vco4NE3RLCRoGzjsnzAd1745408898.png\" width=\"201\"/></p>\n<p style=\"text-align: center;\"><strong>Bitemporal Hemianopia</strong></p>\n<p style=\"text-align: center;\"><strong>(Heteronymous Hemianopia)</strong> <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Tract/ <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> <span class=\"customMeta\" data-dictid=\"00b4dbe9e4169277718881a95f7864\">Geniculate</span> Body (LGB)/ <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"208\" src=\"https://image.prepladder.com/content/6wkip0hL9kZEp4T5x6o11745408903.png\" width=\"203\"/></p>\n<p style=\"text-align: center;\">Homonymous Hemianopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"cab8787ce916927771852a7e72f34d\">Cortex</span> without the involvement of tip</strong></p>\n<p><strong>(Posterior Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers except <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> representation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"214\" src=\"https://image.prepladder.com/content/DOUg9QEh17OdGadyL21x1745408911.png\" width=\"209\"/></p>\n<p style=\"text-align: center;\"><strong>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> Sparing</strong></p>\n<p style=\"text-align: center;\"><strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tip of Visual Cortex</strong></p>\n<p><strong>(Middle Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Macular Representation of <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">Ipsilateral</span> <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> and <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align: center;\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"211\" src=\"https://image.prepladder.com/content/hLPwF3BjCqyOuyQ8xrKN1745408918.png\" width=\"206\"/></p>\n<p style=\"text-align: center;\">Macular <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">Homonymous</span> Hemianopia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with breathlessness and is diagnosed with a Pancoast tumor. Which of the following findings is not typically associated with this condition?", "options": [{"label": "A", "text": "Anhidrosis", "correct": false}, {"label": "B", "text": "Miosis", "correct": false}, {"label": "C", "text": "Ptosis", "correct": false}, {"label": "D", "text": "Exophthalmos", "correct": true}], "correct_answer": "D. Exophthalmos", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:588px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Central lesions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Preganglionic </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Postganglionic </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Brainstem <span class=\"customMeta\" data-dictid=\"54e0888a6616927771945a99208287\">pathology</span> (tumours, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> diseases, demyelinating disorders)</li>\n<li>Spinal cord tumours</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pancoast tumour</li>\n<li>Carotid and Aortic aneurysms</li>\n<li>Neck lesions</li>\n</ul>\n</td>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Atherosclerosis of ICA (internal <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> artery))</li>\n<li>Nasopharyngeal tumours</li>\n<li>Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> pathology</li>\n<li>Cluster headaches</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The lesion in which of the following nerve is responsible for right eye squint, as depicted below?", "options": [{"label": "A", "text": "Oculomotor", "correct": false}, {"label": "B", "text": "Trochlear", "correct": false}, {"label": "C", "text": "Trigeminal", "correct": false}, {"label": "D", "text": "Abducent", "correct": true}], "correct_answer": "D. Abducent", "question_images": ["https://image.prepladder.com/notes/TrSeDSHqNBQJSWClH01D1746444871.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The purpose of the photostress test is to distinguish between:", "options": [{"label": "A", "text": "Macula and optic nerve disease", "correct": true}, {"label": "B", "text": "Cataract and glaucoma", "correct": false}, {"label": "C", "text": "Lens and cornea", "correct": false}, {"label": "D", "text": "Retina and vitreous pathologies", "correct": false}], "correct_answer": "A. Macula and optic nerve disease", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Where is the location of the lesion in Wernicke's hemianopic pupil?", "options": [{"label": "A", "text": "Optic nerve", "correct": false}, {"label": "B", "text": "Optic tract", "correct": true}, {"label": "C", "text": "Optic radiation", "correct": false}, {"label": "D", "text": "Optic chiasma", "correct": false}], "correct_answer": "B. Optic tract", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:735px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Reaction </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Amaurotic light reflex</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Absence of direct light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the affected side and an absence of <span class=\"customMeta\" data-dictid=\"14af60d32316927771855b142ca3ca\">consensual</span> light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the normal side.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> lesions</strong> on the affected side</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Efferent <span class=\"customMeta\" data-dictid=\"3aa5abc2fa169277719488e088076d\">pathway</span> defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Absence of both direct and <span class=\"customMeta\" data-dictid=\"14af60d32316927771855b142ca3ca\">consensual</span> light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the affected side and presence of both direct and <span class=\"customMeta\" data-dictid=\"14af60d32316927771855b142ca3ca\">consensual</span> light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> on the normal side. Near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is also absent on the affected side.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Parasympatholytic drugs (e.g. atropine, homatropine)</li>\n<li>Internal ophthalmoplegia</li>\n<li>Third-nerve paralysis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Marcus Gunn <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> or RAPD </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The pupils paradoxically <span class=\"customMeta\" data-dictid=\"7e9bc153d616927771866a8608d1a5\">dilate</span> when the flashlight is swung from the unaffected to the affected eye due to the decreased light perception.</li>\n<li>It is the first sign of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve disorder.</li>\n<li>Tested by a swinging flashlight test.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Incomplete <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve lesions (Optic neuritis) <strong>(Option A)</strong> and severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> diseases (Retinopathy, CRVO)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Adie’s Pupil</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Reaction to light is absent, and the near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is very slow and tonic.</li>\n<li>It is usually unilateral, associated with absent knee <span class=\"customMeta\" data-dictid=\"b88c1802e21692777190700ee5b998\">jerk</span> and occurs more often in young women.</li>\n<li>It shows pupillary <span class=\"customMeta\" data-dictid=\"4880e9b3761692777185e64eba797c\">constriction</span> to 0.125% <span class=\"customMeta\" data-dictid=\"cad569209a16927771957ef5c7ffab\">Pilocarpine</span> due to <span class=\"customMeta\" data-dictid=\"c35382d7d61692777185a1eeeb333c\">denervation</span> supersensitivity.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Postganglionic <span class=\"customMeta\" data-dictid=\"8f19a37b5916927771941ba9f5ef49\">parasympathetic</span> <span class=\"customMeta\" data-dictid=\"c9fe973c1116927771960115521e92\">pupillomotor</span> damage.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Argyll Robertson <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">Pupil</span> (ARP)</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Reaction to near <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is present, but light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> (both direct and consensual) is absent, i.e. there is light near dissociation.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Neurosyphilis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Wernicke's hemianopic pupil</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> is absent when light is thrown on the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> half of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> of the affected side and the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> half of the opposite side, while it is present when the light is thrown on the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> half of the affected side and the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> half of the opposite side.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> (Option B)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis for a patient who exhibits miosis, anhidrosis, mild ptosis, and a persistent small pupil even in low light conditions?", "options": [{"label": "A", "text": "Adie’s tonic people", "correct": false}, {"label": "B", "text": "Horner syndrome", "correct": true}, {"label": "C", "text": "Marcus gunn pupil", "correct": false}, {"label": "D", "text": "Argyll Robertson pupil", "correct": false}], "correct_answer": "B. Horner syndrome", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - H\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the clinical presentation of a patient with a tumor located in the anterior pituitary gland causing compression on the optic chiasma?", "options": [{"label": "A", "text": "Homonymous hemianopia", "correct": false}, {"label": "B", "text": "Inferior quadrantanopia hemianopia", "correct": false}, {"label": "C", "text": "Bitemporal hemianopia", "correct": true}, {"label": "D", "text": "Superior quadrantanopia hemianopia", "correct": false}], "correct_answer": "C. Bitemporal hemianopia", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/ljeIta1qtHQsvEdNQgc81746707012.png", "https://image.prepladder.com/content/6rsnCwyXlsvvw7LvNSuf1746707095.png"], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"3b17da47ce16927771831d5dde3af3\"&gt;Bitemporal&lt;/span&gt; h\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Maximum visual field is seen in?", "options": [{"label": "A", "text": "Temporal", "correct": true}, {"label": "B", "text": "Nasal", "correct": false}, {"label": "C", "text": "Inferior", "correct": false}, {"label": "D", "text": "Superior", "correct": false}], "correct_answer": "A. Temporal", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - T\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following findings will be observed upon examining the pupil of a 23-year-old male brought to the emergency department after a road traffic accident, who is semiconscious, not alert and oriented to time and space, has a Glasgow Coma Scale (GCS) score of 9/15, and has a stable vital status, with an open wound on the parietal area of the head that has been cleaned and sutured, when further investigations and examinations indicate elevated intracranial pressure?", "options": [{"label": "A", "text": "Ipsilateral mydriasis", "correct": false}, {"label": "B", "text": "Contralateral mydriasis", "correct": false}, {"label": "C", "text": "Ipsilateral miosis", "correct": false}, {"label": "D", "text": "Contralateral miosis", "correct": true}], "correct_answer": "D. Contralateral miosis", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 39-year-old woman arrives at the emergency department with a gradual loss of vision in her left eye over the past three months, as well as blurry vision in her right eye for the past 10 days. She has been experiencing frequent headaches for the past six months, which are worse in the morning and accompanied by nausea and vomiting. She has been taking ondansetron and paracetamol, which have provided some relief. Her visual acuity in her right eye is 20/30, while she can only count fingers with her left eye. An MRI scan reveals a frontal brain lesion on the left side. These findings suggest a diagnosis of Foster-Kennedy syndrome. Which of the following features is not typically seen in Foster-Kennedy syndrome?", "options": [{"label": "A", "text": "Ipsilateral optic atrophy, ipsilateral central scotoma, bilateral progressive optic neuropathy", "correct": false}, {"label": "B", "text": "Contralateral papilledema, ipsilateral central scotoma, bilateral progressive optic neuropathy", "correct": false}, {"label": "C", "text": "Ipsilateral optic atrophy, contralateral papilledema, ipsilateral central scotoma", "correct": false}, {"label": "D", "text": "Contralateral anosmia, Contralateral central scotoma, bilateral progressive optic neuropathy", "correct": true}], "correct_answer": "D. Contralateral anosmia, Contralateral central scotoma, bilateral progressive optic neuropathy", "question_images": ["https://image.prepladder.com/content/7Ni5X4lc9U2GRu0MFfxA1688030173.png"], "explanation_images": [], "explanation": "<p>Correct option D. \n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements accurately describes optic neuritis?", "options": [{"label": "A", "text": "Relative afferent pupillary defect is seen", "correct": true}, {"label": "B", "text": "There is no pain on ocular movement", "correct": false}, {"label": "C", "text": "Multiple myeloma is a common cause", "correct": false}, {"label": "D", "text": "Oral corticosteroids are the mainstay of treatment", "correct": false}], "correct_answer": "A. Relative afferent pupillary defect is seen", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/uORiA2BaYFJUlD26HpwC1745325172.png", "https://image.prepladder.com/notes/5Pe3092375Os2Q5NFa9t1745325122.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:745px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Papillitis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retrobulbar <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neuroretinitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Site </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic disc</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic nerve behind the eyeball.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic disc and surrounding <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> in the <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> area.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristic features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fundoscopy reveals a blurred disc margin due to leakage and increased <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> permeability, edematous and hyperaemic disc, and <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> cup is obliterated.</p>\n<figure class=\"caption_element\"><img alt=\"Temp Papillitis \" data-author=\"Rui Zhang, Jiang Qian, Jie Guo, Yifei Yuan, Kang Xue, Han Yue, Ling Chen\" data-hash=\"10998\" data-license=\"CC BY 4.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1155/2016/2797028\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uORiA2BaYFJUlD26HpwC1745325172.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pain on eye elevation</li>\n<li>RAPD (relative <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> pupillary defect) is observed.</li>\n</ul>\n<ul>\n<li>Fundoscopic examination typically reveals <strong>normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</strong>, at least initially, which is why the classic phrase, “<em>the patient sees nothing, and the doctor sees nothing</em>” is often used to describe <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> neuritis.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> star is seen in fundoscopy (accumulation of lipids).</p>\n<figure class=\"caption_element\"><img alt=\"Temp Neuroretinitis\" data-author=\"Viswanath Gajula, Ravi Kamepalli, Jagadeesh K. Kalavakunta\" data-hash=\"10996\" data-license=\"CC BY NC 3.0\" data-source=\"https://onlinelibrary.wiley.com/doi/10.1002/ccr3.43\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/5Pe3092375Os2Q5NFa9t1745325122.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<br/>\n\t\t\t </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is true about macular opacity?", "options": [{"label": "A", "text": "Iris and pupil are visible", "correct": false}, {"label": "B", "text": "Only pupillary margin is visible", "correct": false}, {"label": "C", "text": "Iris details are visible", "correct": true}, {"label": "D", "text": "Iris and pupillary margin are not visible", "correct": false}], "correct_answer": "C. Iris details are visible", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Tl6arBWMfrd9db3bqGCg1741789564.png", "https://image.prepladder.com/content/Q8SWazOyHfBpfhX3ufrw1741277899.png", "https://image.prepladder.com/content/MFStUlk1X4lLb7jsEwPQ1741789660.png", "https://image.prepladder.com/content/cyElWA4zO0rBCAxlTQtZ1741789684.png", "https://image.prepladder.com/content/X77p3EwuFY9jNAYIsUah1741789703.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 5-month-old baby is brought by the mother with complaints of the left upper eyelid moving up and down during breastfeeding or thumb sucking, which disappears when the baby is not being fed. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Marcus Gunn Jaw-Winking Syndrome", "correct": true}, {"label": "B", "text": "Lagophthalmos", "correct": false}, {"label": "C", "text": "Myasthenia Gravis", "correct": false}, {"label": "D", "text": "3rd CN palsy", "correct": false}], "correct_answer": "A. Marcus Gunn Jaw-Winking Syndrome", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/lYed476bmt0uk0xXWNvS1741088005.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the visual field defect:", "options": [{"label": "A", "text": "Altitudinal defect", "correct": false}, {"label": "B", "text": "Roennes nasal step", "correct": false}, {"label": "C", "text": "Blind spot enlargement", "correct": true}, {"label": "D", "text": "Arcuate scotoma", "correct": false}], "correct_answer": "C. Blind spot enlargement", "question_images": ["https://image.prepladder.com/content/RwCVQUk05g2L1W0ixkHJ1724828138.png"], "explanation_images": ["https://image.prepladder.com/content/ydOBTBDoBF5Oo3msoQY31724828359.png", "https://image.prepladder.com/content/fsCEKlTiYHBdHGIruQEv1724828376.png", "https://image.prepladder.com/content/UpoPh6SX6CgVsIs4wgS11724828401.png", "https://image.prepladder.com/content/BDj76ykCj93eiBN4KR0H1724828423.png"], "explanation": "<p>Correct Option C - Blind spot enlarg\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the defect shown in the image given below:", "options": [{"label": "A", "text": "Binasal hemianopia", "correct": false}, {"label": "B", "text": "Bitemporal hemianopia", "correct": false}, {"label": "C", "text": "Homonymous hemianopia", "correct": true}, {"label": "D", "text": "Altitudinal defect", "correct": false}], "correct_answer": "C. Homonymous hemianopia", "question_images": ["https://image.prepladder.com/content/t5TYzgvIGmd5koHHzCaS1724757126.png"], "explanation_images": ["https://image.prepladder.com/content/AuvqCY8ouF4cPln8HCM21724910043.png"], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\"&gt;Homonymous&lt;/span&gt; h\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Sudden painful loss of vision in one eye is due to the lesion at?", "options": [{"label": "A", "text": "Optic nerve", "correct": true}, {"label": "B", "text": "Optic chiasma", "correct": false}, {"label": "C", "text": "Optic tract", "correct": false}, {"label": "D", "text": "Visual cortex", "correct": false}], "correct_answer": "A. Optic nerve", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Y2C9gAaIM9kVdG1oodAi1747306594.png", "https://image.prepladder.com/content/D0xm0B3TIXxCyxSYME711747306594.png", "https://image.prepladder.com/content/NFm06pHP2wpVinaFPyBL1747306594.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Papillitis </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Retrobulbar <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">Neuritis</span> </strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Neuroretinitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Site </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic disc</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic nerve behind the eyeball.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Optic disc and surrounding <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> in the <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> area.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Characteristic features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Fundoscopy reveals a blurred disc margin due to leakage and increased <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> permeability, an edematous and hyperaemic disc, and an obliterated <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> cup.</p>\n<p> </p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"Open access\" data-source=\"https://www.cdc.gov/dpdx/freelivingamebic/index.html\" data-tags=\"\" height=\"225\" src=\"https://image.prepladder.com/content/Y2C9gAaIM9kVdG1oodAi1747306594.png\" width=\"296\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pain on eye elevation</li>\n<li>RAPD (relative <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> pupillary defect) is observed.</li>\n</ul>\n<ul>\n<li>Fundoscopic examination typically reveals <strong>normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</strong>, at least initially, which is why the classic phrase, “<em>the patient sees nothing, and the doctor sees nothing</em>” is often used to describe <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> neuritis.</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> star is seen in fundoscopy (accumulation of lipids).</p>\n<p> </p>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Rasta, Seyed &amp; Nikfarjam, Shima &amp; Javadzadeh, Alireza.\" data-hash=\"\" data-license=\"CC BY NC 4.0\" data-source=\"https://www.researchgate.net/figure/FFA-image-in-presence-of-neovascularization-and-vascular-permeability_fig4_298082808\" data-tags=\"\" height=\"224\" src=\"https://image.prepladder.com/content/D0xm0B3TIXxCyxSYME711747306594.png\" width=\"279\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Optic nerve glioma is seen in?", "options": [{"label": "A", "text": "NF-1", "correct": true}, {"label": "B", "text": "Tuberous sclerosis", "correct": false}, {"label": "C", "text": "NF-2", "correct": false}, {"label": "D", "text": "Schwannoma", "correct": false}], "correct_answer": "A. NF-1", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Leukocoria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Congenital cataract</li>\n<li>Inflammatory deposits in <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> following a plastic <span class=\"customMeta\" data-dictid=\"fd270d89c016927771857f2dcac3fd\">cyclitis</span> or choroiditis,</li>\n<li>Coloboma of the choroid,</li>\n<li>Retinopathy of prematurity<strong> </strong></li>\n<li>Persistent hyperplastic primary vitreous</li>\n<li>Toxocara endophthalmitis</li>\n<li>Exudative <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> of Coats</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Endophytic retinoblastoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Tuberous sclerosis</li>\n<li><strong>Neurofibromatosis-1 (Option A)</strong></li>\n<li>Astrocytoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Exophytic Retinoblastoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Exudative <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> of Coats</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which tuberculosis drug causes impairment of color vision and optic neuritis?", "options": [{"label": "A", "text": "Rifampicin", "correct": false}, {"label": "B", "text": "Ethambutol", "correct": true}, {"label": "C", "text": "Pyrazinamide", "correct": false}, {"label": "D", "text": "Streptomycin", "correct": false}], "correct_answer": "B. Ethambutol", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:712px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Ethambutol</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inhibits arabinosyl transferases involved in arabinogalactan synthesis, thereby <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in cell wall</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism of resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mutation of embAB genes, which encodes the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> arabinosyl transferase, reducing its <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for ethambutol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>In the treatment of</p>\n<ul>\n<li>Mycobacterium tuberculosis</li>\n<li>Mycobacterium avium complex (MAC)</li>\n<li>Mycobacterium kansasii</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Painless loss of vision\n\t\t\t\t<ul>\n<li><strong>Field defects due to <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> (Option C)</strong></li>\n<li>Loss of visual acuity</li>\n<li>Red-green colour blindness</li>\n</ul>\n</li>\n<li>Nausea, rashes, fever</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which nerve defect causes lagophthalmos?", "options": [{"label": "A", "text": "7th nerve", "correct": true}, {"label": "B", "text": "6th nerve", "correct": false}, {"label": "C", "text": "4th nerve", "correct": false}, {"label": "D", "text": "5th nerve", "correct": false}], "correct_answer": "A. 7th nerve", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Most common cause of <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> palsy</li>\n<li>Characterized by idiopathic, <strong>LMN <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> paralysis</strong> of <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> onset</li>\n<li><strong>Most commonly the Labyrinthine segment</strong> of the <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> nerve is involved.</li>\n<li><strong>Males and females are equally affected.</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aetiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Idiopathic: Most common cause</strong></li>\n<li>Viral Infection: <strong>HSV</strong> &gt;&gt; Herpes zoster</li>\n<li>Vascular Ischemia</li>\n<li>Hereditary: Positive family history in 6-8%</li>\n<li>Autoimmune</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>More common in diabetics (due to angiopathy) and pregnant women (due to fluid retention).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sudden onset of <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> with inability to close the eye (Bell's phenomenon)<strong> (Option A)</strong>, <span class=\"customMeta\" data-dictid=\"0bead1317716927771827dc3e80706\">asymmetry</span> of the face, epiphora, drooping mouth, and dribbling of saliva.</li>\n<li>Associated symptoms may include ear pain, noise <span class=\"customMeta\" data-dictid=\"7794e5fd7a1692777190ee626ede62\">intolerance</span> (stapedial paralysis), or loss of taste (chorda tympani involvement).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diagnosis is made by excluding other causes of <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> paralysis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>General: Reassurance, pain relief, eye protection and physiotherapy</li>\n<li>Medical: <strong>Prednisolone</strong> 60 mg per day for 5 days then <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> by 10 mg per day (for a total treatment time of 10 days) and 50 mg per day (in two divided doses) for 10 days, <strong>Acyclovir</strong></li>\n<li>Surgical: Nerve decompression</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prognosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>85%-90% of patients fully recover </strong></li>\n<li>Incomplete resolution are mainly seen in recurrent/late recovery cases</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient on antitubercular therapy (ATT) started experiencing visual problems. Which ATT drug is most likely responsible for this adverse effect?", "options": [{"label": "A", "text": "Rifampicin", "correct": false}, {"label": "B", "text": "Streptomycin", "correct": false}, {"label": "C", "text": "Ethambutol", "correct": true}, {"label": "D", "text": "Pyrazinamide", "correct": false}], "correct_answer": "C. Ethambutol", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ethambutol</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>MOA</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inhibits arabinosyl transferases involved in arabinogalactan synthesis, thereby <span class=\"customMeta\" data-dictid=\"653140d1dc16927771903445309f4e\">interfering</span> with mycolic acid <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> in cell wall</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanism of resistance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mutation of embAB genes, which encodes the <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> arabinosyl transferase, reducing its <span class=\"customMeta\" data-dictid=\"227269f3ec1692777180d76a7898dd\">affinity</span> for ethambutol</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>In the treatment of</p>\n<ul>\n<li>Mycobacterium tuberculosis</li>\n<li>Mycobacterium avium complex (MAC)</li>\n<li>Mycobacterium kansasii</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Side effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Painless loss of vision\n\t\t\t\t<ul>\n<li><strong>Field defects due to <span class=\"customMeta\" data-dictid=\"99ac6e31f71692777197220f87effc\">retrobulbar</span> <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> (Option C)</strong></li>\n<li>Loss of visual acuity</li>\n<li>Red-green colour blindness</li>\n</ul>\n</li>\n<li>Nausea, rashes, fever</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the provided image, which nerve is subjected to blockage?", "options": [{"label": "A", "text": "Anterior ethmoidal nerve", "correct": false}, {"label": "B", "text": "Nasociliary nerve", "correct": true}, {"label": "C", "text": "Supratrochlear nerve", "correct": false}, {"label": "D", "text": "Long ciliary nerve", "correct": false}], "correct_answer": "B. Nasociliary nerve", "question_images": ["https://image.prepladder.com/notes/vMG8iEShVM8JBuhtJGr11746178469.png"], "explanation_images": ["https://image.prepladder.com/notes/vMG8iEShVM8JBuhtJGr11746178469.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a female patient, there is a complaint of vision loss, specifically affecting the right halves of both eyes. Where is the lesion located?", "options": [{"label": "A", "text": "Optic nerve", "correct": false}, {"label": "B", "text": "Left optic tract", "correct": true}, {"label": "C", "text": "Optic chiasma", "correct": false}, {"label": "D", "text": "Right optic tract", "correct": false}], "correct_answer": "B. Left optic tract", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/j3pGsqQG9ZUQpYW2XRf71745317015.png", "https://image.prepladder.com/content/6fXMVnwElzkObvLzQXtd1745317044.png", "https://image.prepladder.com/content/v3QXGL32BM9AtoazhLSq1745317051.png", "https://image.prepladder.com/content/V6e4Kqb8cGo34StHHu8o1745317058.png", "https://image.prepladder.com/content/44axlJZhpNFSuucStWVM1745317064.png", "https://image.prepladder.com/content/1IGz3Ee0Vc3gfZchGDxV1745317071.png", "https://image.prepladder.com/content/Pk1nARXkMXiyb8hHfoPN1745317079.png", "https://image.prepladder.com/content/YkQJVVX4Pf4BLthw81mR1745317084.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Visual Pathway Lesions and Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Site of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Fibers Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Field Defect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> + Nasal Fibers <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"278\" src=\"https://image.prepladder.com/content/6fXMVnwElzkObvLzQXtd1745317044.png\" width=\"297\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Anopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bilateral Nasal Fibers <strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"307\" src=\"https://image.prepladder.com/content/v3QXGL32BM9AtoazhLSq1745317051.png\" width=\"313\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Bitemporal Hemianopia</strong></p>\n<p style=\"text-align:center\"><strong>(Heteronymous Hemianopia)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Optic Tract</strong></li>\n<li><strong>Lateral Geniculate Body (LGB Lesion)</strong></li>\n<li><strong>Optic Radiation</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> Nasal Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"313\" src=\"https://image.prepladder.com/content/V6e4Kqb8cGo34StHHu8o1745317058.png\" width=\"313\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Homonymous Hemianopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Cortex without the involvement of tip</strong></p>\n<p><strong>(Post. Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> Nasal Fibers except <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> representation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"313\" src=\"https://image.prepladder.com/content/44axlJZhpNFSuucStWVM1745317064.png\" width=\"313\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> Sparing</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tip of Visual Cortex</strong></p>\n<p><strong>(Middle Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Macular Representation of Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> and <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> Nasal Fibers.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"313\" src=\"https://image.prepladder.com/content/1IGz3Ee0Vc3gfZchGDxV1745317071.png\" width=\"313\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p style=\"text-align:center\"><strong>Macular <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">Homonymous</span> Hemianopia</strong></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Inferior <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiations</strong></p>\n<p style=\"text-align:center\"><strong>(Meyer’s Loop)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Superior <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiations</strong></p>\n<p style=\"text-align:center\"><strong>(Baum’s Loop)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Temporal <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parietal lobe</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Affected Visual Field</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior quadrants of the <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> visual field</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inferior quadrants of the <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> visual field</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual Defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> <span class=\"customMeta\" data-dictid=\"e0b79d0fde16927771965173ff3031\">quadrantanopia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> <span class=\"customMeta\" data-dictid=\"e0b79d0fde16927771965173ff3031\">quadrantanopia</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Associated Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Memory loss</li>\n<li>Hearing loss</li>\n<li>Auditory hallucinations</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Contralateral hemiplegia</li>\n<li>Hemianesthesia</li>\n<li>Optokinetic nystagmus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"275\" src=\"https://image.prepladder.com/content/Pk1nARXkMXiyb8hHfoPN1745317079.png\" width=\"275\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"152\" src=\"https://image.prepladder.com/content/YkQJVVX4Pf4BLthw81mR1745317084.png\" width=\"281\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old male patient presents with altered sensation in the extremities, difficulty with coordination, and speech problems. On examination, it is noted that the pupillary light reaction is absent, but the accommodation reaction is present. Which condition is most likely responsible for this presentation?", "options": [{"label": "A", "text": "Neurosyphilis", "correct": true}, {"label": "B", "text": "Horner's syndrome", "correct": false}, {"label": "C", "text": "Papilledema", "correct": false}, {"label": "D", "text": "Optic Neuritis", "correct": false}], "correct_answer": "A. Neurosyphilis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/62TQBD1isJ12KSZOnAJX1746429220.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What are the yoke muscles for Levodepression?", "options": [{"label": "A", "text": "LSO and RIR", "correct": false}, {"label": "B", "text": "RSO and LIR", "correct": true}, {"label": "C", "text": "RIO and LIR", "correct": false}, {"label": "D", "text": "LIO and RIR", "correct": false}], "correct_answer": "B. RSO and LIR", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/gpmkwAKMQ3WPFwNagliL1747393150.png", "https://image.prepladder.com/notes/lLOZoyGFfJgoIRpDgWDW1747393165.png"], "explanation": "<p>Correct Answer B - RSO and LIR\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents to the OPD with the given visual field effect. What is the probable site of the lesion based on the image displayed?", "options": [{"label": "A", "text": "3", "correct": true}, {"label": "B", "text": "1", "correct": false}, {"label": "C", "text": "4", "correct": false}, {"label": "D", "text": "6", "correct": false}], "correct_answer": "A. 3", "question_images": ["https://image.prepladder.com/content/DIX6GkV0BjGaHgGrhx9q1746429968.png", "https://image.prepladder.com/notes/s6JznnbxVSkq6jLPXu5p1747393356.png"], "explanation_images": ["https://image.prepladder.com/content/4r0YsDCmvS2lKkrULXZI1746430013.png", "https://image.prepladder.com/content/PCcWxdiSL76hsVQK8fFh1746430080.png", "https://image.prepladder.com/content/0sLsFJGoYXc2RaZ6cCqd1746430088.png", "https://image.prepladder.com/notes/6WgxMapC3W4lUtpB9q8n1747393583.png", "https://image.prepladder.com/content/zcxkVnDtzZ40Xy2S7pFT1746430111.png", "https://image.prepladder.com/content/bGGvacH6h1f6NZEqZwOA1746430121.png", "https://image.prepladder.com/content/C1cPdl5LQnFfqCU1eGMi1746430315.png", "https://image.prepladder.com/content/4VIWLEqI9YG5FnDlron91746430299.png"], "explanation": "<p>Correct Answer A - 3</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"3\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Visual Pathway Lesions and Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Site of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Fibers Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Field Defect</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Nerve</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> + <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"313\" src=\"https://image.prepladder.com/content/PCcWxdiSL76hsVQK8fFh1746430080.png\" width=\"313\"/></p>\n<p style=\"text-align:center\"><strong>Anopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optic Chiasma</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"308\" src=\"https://image.prepladder.com/content/0sLsFJGoYXc2RaZ6cCqd1746430088.png\" width=\"313\"/></p>\n<p style=\"text-align:center\"><strong>Bitemporal Hemianopia</strong></p>\n<p style=\"text-align:center\"><strong>(Heteronymous Hemianopia)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Optic Tract (Option C ruled out)</strong></li>\n<li><strong>Lateral Geniculate Body (LGB Lesion)</strong></li>\n<li><strong>Optic Radiation</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"Homonymous hemianopia\" data-author=\"\" data-hash=\"12838\" data-license=\"\" data-source=\"\" data-tags=\"May2025\" height=\"170\" src=\"https://image.prepladder.com/notes/6WgxMapC3W4lUtpB9q8n1747393583.png\" width=\"300\"/></p>\n<p style=\"text-align:center\"><strong>Right <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">Homonymous</span> Hemianopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Visual Cortex without the involvement of tip</strong></p>\n<p><strong>(Post. Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> Fibers + <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers except <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> representation</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"319\" src=\"https://image.prepladder.com/content/zcxkVnDtzZ40Xy2S7pFT1746430111.png\" width=\"313\"/></p>\n<p style=\"text-align:center\"><strong>Homonymous <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">Hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> Sparing</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Tip of Visual Cortex</strong></p>\n<p><strong>(Middle Cerebral Artery)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Macular Representation of Ipsilateral <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">Temporal</span> and <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">Contralateral</span> <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">Nasal</span> Fibers.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"319\" src=\"https://image.prepladder.com/content/bGGvacH6h1f6NZEqZwOA1746430121.png\" width=\"313\"/></p>\n<p style=\"text-align:center\"><strong>Macular <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">Homonymous</span> Hemianopia</strong></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Inferior <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiations (Meyer’s Loop)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Superior <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">Optic</span> Radiations (Baum’s Loop)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Location of Lesion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Temporal <span class=\"customMeta\" data-dictid=\"d7dd6ae43c1692777191cf75c0bd58\">lobe</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Parietal lobe</strong> <strong>(Option D ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Affected Visual Field</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Superior quadrants of the <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> visual field</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inferior quadrants of the <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> visual field</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Visual Defect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Superior <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> quadrantanopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Inferior <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> quadrantanopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Associated Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Memory loss</li>\n<li>Hearing loss</li>\n<li>Auditory hallucinations</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Contralateral hemiplegia</li>\n<li>Hemianesthesia</li>\n<li>Optokinetic nystagmus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"299\" src=\"https://image.prepladder.com/content/C1cPdl5LQnFfqCU1eGMi1746430315.png\" width=\"299\"/></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"177\" src=\"https://image.prepladder.com/content/4VIWLEqI9YG5FnDlron91746430299.png\" width=\"277\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which muscle serves as the yoke muscle for the right lateral rectus?", "options": [{"label": "A", "text": "Right superior oblique", "correct": false}, {"label": "B", "text": "Left medial rectus", "correct": true}, {"label": "C", "text": "Left lateral rectus", "correct": false}, {"label": "D", "text": "Right medial rectus", "correct": false}], "correct_answer": "B. Left medial rectus", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/BgiPbc3sAqfahQo8k3871746432089.png", "https://image.prepladder.com/content/VszAkGbn6XLvBfAupsvD1746432101.png"], "explanation": "<p>Correct Answer B - Left &lt;span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\"&gt;medial&lt;/span&gt; rectu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which disease is associated with bilateral optic neuritis and transverse myelitis?", "options": [{"label": "A", "text": "Schilder disease", "correct": false}, {"label": "B", "text": "Parainfectious optic neuritis", "correct": false}, {"label": "C", "text": "Neuromyelitis optica", "correct": true}, {"label": "D", "text": "Multiple sclerosis", "correct": false}], "correct_answer": "C. Neuromyelitis optica", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Neu\n<table>\n<tbody>\n<tr>\n<td>\n<p style=\"text-align:center\"><strong>Aspect</strong></p>\n</td>\n<td>\n<p style=\"text-align:center\"><strong>Neuromyelitis Optica (NMO)</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Definition</p>\n</td>\n<td>\n<p>Neuromyelitis Optica (NMO), also known as Devic's disease, is a rare <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> disorder that primarily affects the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerves and <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord. It is characterized by <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> episodes of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"6e951a16031692777193af1c351309\">neuritis</span> and <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">transverse</span> myelitis.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Etiology</p>\n</td>\n<td>\n<p>NMO is associated with the presence of autoantibodies called aquaporin-4 (AQP4) antibodies, which target the AQP4 <span class=\"customMeta\" data-dictid=\"2860fb05a316927772020985f74bf7\">water channel</span> protein found on astrocytes in the central nervous system.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Clinical Features</p>\n</td>\n<td>\n<p>Optic Neuritis: <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">Inflammation</span> of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve causing vision loss, pain, and eye movement difficulties. &lt;br&gt; - <span class=\"customMeta\" data-dictid=\"a6260fa86416927772008d36bd7e5f\">Transverse</span> Myelitis: <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">Inflammation</span> of the <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> cord leading to sensory, motor, and <span class=\"customMeta\" data-dictid=\"bd1c98736616927771820954b0a744\">autonomic</span> dysfunction.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presented with tabes dorsalis. What will be observed when his pupils are exposed to light?", "options": [{"label": "A", "text": "Pupils react but do not accommodate", "correct": false}, {"label": "B", "text": "Pupils accommodate but do not react", "correct": true}, {"label": "C", "text": "Pupils neither react not accommodate", "correct": false}, {"label": "D", "text": "Pupils react and accommodate", "correct": false}], "correct_answer": "B. Pupils accommodate but do not react", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Pupils accommodate bu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the site of lesion in internuclear ophthalmoplegia?", "options": [{"label": "A", "text": "Medial Longitudinal Fasciculus", "correct": true}, {"label": "B", "text": "6th nerve nucleus", "correct": false}, {"label": "C", "text": "Pontine paramedian reticular formation", "correct": false}, {"label": "D", "text": "AC", "correct": false}], "correct_answer": "A. Medial Longitudinal Fasciculus", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Medial &lt;span class=\"customMeta\" data-dictid=\"7ba18aa5e616927771918a45051a40\"&gt;Longitudinal&lt;/span&gt; Fasciculus:</p>\n<p><strong>References:</strong></p>\n<ul><li>↳ Options B, C, and D are incorrect. Refer to Option A for reference.</li><li>↳ Options B, C, and D</li></u\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions is characterized by the presence of ipsilateral third nerve palsy and contralateral hemiparesis?", "options": [{"label": "A", "text": "Weber syndrome", "correct": true}, {"label": "B", "text": "Benedikt syndrome", "correct": false}, {"label": "C", "text": "Millard-Gubler syndrome", "correct": false}, {"label": "D", "text": "Foville's syndrome", "correct": false}], "correct_answer": "A. Weber syndrome", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - W\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What type of field defects arise from a lesion located at the optic chiasma ?", "options": [{"label": "A", "text": "Bitemporal hemianopia", "correct": true}, {"label": "B", "text": "Unilateral blindness", "correct": false}, {"label": "C", "text": "Pie on the floor", "correct": false}, {"label": "D", "text": "Homonymous hemianopia Bilateral homonymous macular defect", "correct": false}], "correct_answer": "A. Bitemporal hemianopia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Lesion Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Effect on Visual Field</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic Nerve</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unilateral loss of vision in the affected eye</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic Chiasm</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bitemporal hemianopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic Tract</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contralateral <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> hemianopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Temporal radiation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pie in the sky/superior quadrantanopia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> radiation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pie on the floor/inferior quadrantanopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Visual Cortex</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contralateral <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> sparing</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Where is the location of the lesion resulting in the following visual field defect ?", "options": [{"label": "A", "text": "Anterior parietal radiations", "correct": false}, {"label": "B", "text": "Optic tract", "correct": false}, {"label": "C", "text": "Optic chiasma", "correct": false}, {"label": "D", "text": "Temporal radiations", "correct": true}], "correct_answer": "D. Temporal radiations", "question_images": ["https://image.prepladder.com/content/JSdLamn7qNceXCnDlG1v1691412227.png"], "explanation_images": [], "explanation": "<p>Correct Option D - \n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lesion Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Effect on Visual Field</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic Nerve</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Unilateral loss of vision in the affected eye</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic Chiasm</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bitemporal hemianopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Optic Tract</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contralateral <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> hemianopia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Temporal radiations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior quadrantanopia/pie in the sky</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior <span class=\"customMeta\" data-dictid=\"51df38de3d1692777194ced4c4bab5\">parietal</span> radiations</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inferior quadrantanopia/pie on the floor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Visual Cortex</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contralateral <span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\">homonymous</span> <span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\">hemianopia</span> with <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> sparing</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the correct information about the image provided below?", "options": [{"label": "A", "text": "It is called Argyl Robertson pupil", "correct": false}, {"label": "B", "text": "Both eyes are abnormal", "correct": false}, {"label": "C", "text": "Right eye is normal", "correct": false}, {"label": "D", "text": "Seen in optic neuritis", "correct": true}], "correct_answer": "D. Seen in optic neuritis", "question_images": ["https://image.prepladder.com/content/iuiEOBFuyWUk298tUCEG1691652322.png"], "explanation_images": [], "explanation": "<p>Correct Option D - Seen in &lt;span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\"&gt;optic&lt;/span&gt; neu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 40-year-old male patient presents with altered sensation in the extremities, difficulty with coordination, and speech problems. On examination, it is noted that the pupillary light reaction is absent, but the accommodation reaction is present. Which condition is most likely responsible for this presentation?", "options": [{"label": "A", "text": "Neurosyphilis", "correct": true}, {"label": "B", "text": "Horner’s syndrome", "correct": false}, {"label": "C", "text": "Papilledema", "correct": false}, {"label": "D", "text": "Optic Neuritis", "correct": false}], "correct_answer": "A. Neurosyphilis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Neurosyph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old male arrived at the emergency ward with sudden vision loss and experiencing painful eye movements . Upon examination, the affected eye shows a relative afferent pupillary defect, a normal optic disc , and a central scotoma . What is the likely diagnosis?", "options": [{"label": "A", "text": "Optic nerve glioma", "correct": false}, {"label": "B", "text": "Optic neuritis", "correct": true}, {"label": "C", "text": "Eale’s disease", "correct": false}, {"label": "D", "text": "Optic atrophy", "correct": false}], "correct_answer": "B. Optic neuritis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Optic neu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 54 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 6-month old baby was brought to the clinic with the following finding. Which among the following statements is incorrect regarding the likely diagnosis?", "options": [{"label": "A", "text": "More common in boys", "correct": true}, {"label": "B", "text": "Undergoes spontaneous regression in majority", "correct": false}, {"label": "C", "text": "Oral propranolol can be used for treating this condition", "correct": false}, {"label": "D", "text": "Most common orbital tumor of children.", "correct": false}], "correct_answer": "A. More common in boys", "question_images": ["https://image.prepladder.com/notes/Gc9HtApEiuBnx36AYDVw1743664940.png"], "explanation_images": ["https://image.prepladder.com/notes/8IRFOjaGrtSHDYzlgqVn1743665124.png", "https://image.prepladder.com/notes/A5RAbNeBOFIf263EgXQd1743665183.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Most common <strong>orbital tumor</strong> in children <strong>(Option D)</strong></li>\n<li>More common in girls than boys (<strong>3:2 ratio</strong>) <strong>(Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset &amp; Growth</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Visible at birth in about one-third of cases</li>\n<li>Rapid <span class=\"customMeta\" data-dictid=\"864fe16d151692777188d02c9fe3be\">growth phase</span> in the first 6 months</li>\n<li><strong>~75% regress</strong> by 7 years old <strong>spontaneously (Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Red, raised <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">nodular</span> mass (\"strawberry nevus\")</li>\n<li>Deep <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> mass: <span class=\"customMeta\" data-dictid=\"4edef7912e1692777196cb0f66e35d\">proptosis</span> and globe displacement</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lobules of plump endothelial cells separated by <span class=\"customMeta\" data-dictid=\"5d6dfa73b316927772028f3cd60f7f\">fibrous</span> septa</li>\n</ul>\n<img alt=\"OP272\" data-author=\"\" data-hash=\"6877\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/8IRFOjaGrtSHDYzlgqVn1743665124.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Only done for complicated cases (affecting vision loss, systemic,etc.) and for <span class=\"customMeta\" data-dictid=\"ff63f91a5e16927771858327cda029\">cosmetic</span> indications.</li>\n<li><strong>Oral Propranolol (Option C)</strong></li>\n<li>Intralesional corticosteroid</li>\n<li>Radiotherapy/Cryotherapy</li>\n<li>Surgery</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Benign Tumors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Papilloma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Most common <span class=\"customMeta\" data-dictid=\"1bbae82f1f16927771824f797639fa\">benign</span> tumor arising from surface epithelium</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Xanthelasma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Middle aged woman, <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> deposits present within histiocytes</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Hemangioma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Capillary &amp; Cavernous hemangioma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Neurofibroma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Variant called Plexiform neurofibroma:</li>\n<li>S-shaped appearance</li>\n<li>Bag of worms feel on palpation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Keratoacanthoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Non-pigmented <span class=\"customMeta\" data-dictid=\"08b787c5a41692777196c0e16b3805\">protrusion</span> with <span class=\"customMeta\" data-dictid=\"d0e68b82ed1692777190fa10f7d4ba\">keratin</span> filled central crater</li>\n</ul>\n<br/>\n<img alt=\"OP273\" data-author=\"\" data-hash=\"6878\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/A5RAbNeBOFIf263EgXQd1743665183.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Naevi</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Congenital naevi ; Acquired naevi</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pre-Malignant Tumors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Actinic keratosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Over sun-exposed areas</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Xeroderma pigmentosum </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Defective <span class=\"customMeta\" data-dictid=\"94a2f0970016927771932885a3d362\">nucleotide</span> <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">excision</span> repair</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Malignant Tumors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Basal cell cancer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Most common <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">malignant</span> tumor of eyelid</strong></li>\n<li>Most common site: lower lid &gt; <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> canthus</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Squamous cell cancer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>2nd most common <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">malignant</span> tumor of eyelid</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Sebaceous <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> carcinoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Recurrence - common</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Malignant melanoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Most common type: <span class=\"customMeta\" data-dictid=\"ebb480187d1692777199e233e9e356\">superficial</span> <span class=\"customMeta\" data-dictid=\"ad56eb6e551692777199ae4ce59798\">spreading</span> type</li>\n<li>Worst <span class=\"customMeta\" data-dictid=\"e580b4033e169277719609af594c16\">prognosis</span> type: <span class=\"customMeta\" data-dictid=\"bfa856c77716927771939978c5afd0\">Nodular</span> melanoma</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rpyyPmvMN69DKi4DRJkx1747643216.mp3", "video": ""}, {"text": "Match the image with the condition: Image Condition a. Chronic painless swelling 1. Stye b. Acute painful swelling 2. Chalazion c. Acute painful Swelling 3. Hordeolum Internum", "options": [{"label": "A", "text": "a-2,b-3,c-1", "correct": true}, {"label": "B", "text": "a-1,b-2,c-3", "correct": false}, {"label": "C", "text": "a-3,b-2,c-1", "correct": false}, {"label": "D", "text": "a-1,b-3,c-2", "correct": false}], "correct_answer": "A. a-2,b-3,c-1", "question_images": ["https://image.prepladder.com/notes/ShkZzU1b5e9OZlxvkYdW1743666133.png", "https://image.prepladder.com/notes/XDXc2dDwQdVmxx6R6Unm1747212213.png", "https://image.prepladder.com/notes/OB5omn08ZAZlxWlnT9N61747212119.png"], "explanation_images": ["https://image.prepladder.com/notes/OB5omn08ZAZlxWlnT9N61747212119.png", "https://image.prepladder.com/notes/XDXc2dDwQdVmxx6R6Unm1747212213.png", "https://image.prepladder.com/notes/ShkZzU1b5e9OZlxvkYdW1743666133.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Condition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Definition &amp; Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hordeolum externum</strong><strong> (Stye)</strong></p>\n<br/>\n<img alt=\"Hordeolum externum\" data-author=\"\" data-hash=\"12686\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/OB5omn08ZAZlxWlnT9N61747212119.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Acute <span class=\"customMeta\" data-dictid=\"a48a50d87216927771994f1cfe9b7d\">suppurative</span> painful inflammation</strong> of a lash <span class=\"customMeta\" data-dictid=\"b0c3f6b8901692777203d0446fe1f4\">follicle</span> and associated glands of Zeis or Moll.</li>\n<li>Most common <span class=\"customMeta\" data-dictid=\"f616aee08b169277718361438e1a91\">causative</span> organism - Staphylococcus aureus.</li>\n<li>Symptoms: Acute pain with <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> on the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> lid margin, watering and photophobia.</li>\n</ul>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hot compresses 2-3 times daily.</li>\n<li>Evacuate <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">pus</span> by epilating involved <span class=\"customMeta\" data-dictid=\"c3ceefdd5c16927771840391a4a4a4\">cilia</span> when <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">pus</span> point forms.</li>\n<li>Rarely, <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> for large abscess.</li>\n<li>Antibiotic <span class=\"customMeta\" data-dictid=\"fe2c08a01b1692777187011e915049\">eye drops</span> and ointment.</li>\n<li>Systemic anti-inflammatory and analgesics.</li>\n<li>Systemic antibiotics for early infection control.</li>\n<li>Identify and treat <span class=\"customMeta\" data-dictid=\"80c0cb2a5f1692777196ba45847553\">predisposing</span> conditions in <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> cases.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hordeolum Internum</strong></p>\n<p><img alt=\"Hordeolum internum\" data-author=\"\" data-hash=\"12687\" data-license=\"\" data-source=\"\" data-tags=\"\" src=\"https://image.prepladder.com/notes/XDXc2dDwQdVmxx6R6Unm1747212213.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute <span class=\"customMeta\" data-dictid=\"a48a50d87216927771994f1cfe9b7d\">Suppurative</span> painful inflammation of the <span class=\"customMeta\" data-dictid=\"b02162faf616927771928106bcbf94\">meibomian</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> with <span class=\"customMeta\" data-dictid=\"6198b5f22b16927771867e4ef8108f\">duct</span> blockage.</li>\n</ul>\n<br/>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Similar to <span class=\"customMeta\" data-dictid=\"52eee1503416927771878c347be662\">external hordeolum</span> treatment.</li>\n<li>Drain <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">pus</span> by a vertical <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> from the <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> when <span class=\"customMeta\" data-dictid=\"e4626b4cea16927771968e59732fef\">pus</span> forms.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chalazion</strong><img alt=\"OP285\" data-author=\"\" data-hash=\"6893\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ShkZzU1b5e9OZlxvkYdW1743666133.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic <strong>non-infective lipogranulomatous inflammation </strong>of the <span class=\"customMeta\" data-dictid=\"b02162faf616927771928106bcbf94\">meibomian</span> gland.</li>\n<li><strong>Painless </strong>swelling of the eyelid, mild heaviness, blurred vision.</li>\n<li>Nodule is present slightly away from the lid margin.</li>\n<li>Malignant change into <span class=\"customMeta\" data-dictid=\"b02162faf616927771928106bcbf94\">meibomian</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> <span class=\"customMeta\" data-dictid=\"362992dbb11692777180f9017fc04d\">adenocarcinoma</span> may be seen in elderly.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Conservative treatment: Hot fomentation, <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> antibiotics, oral anti-inflammatory drugs.</li>\n<li>Intralesional <span class=\"customMeta\" data-dictid=\"a48ce797cd1692777199efc43b3e4c\">steroid</span> <span class=\"customMeta\" data-dictid=\"3509997646169277719014053aa74d\">injection</span> (triamcinolone).</li>\n<li>Incision (<strong>vertical</strong> on the conjunctival side, and <strong>horizontal </strong>on skin side), and <span class=\"customMeta\" data-dictid=\"f857ee35331692777185a5895e53b5\">curettage</span> for conventional treatment.</li>\n<li>Diathermy for marginal chalazion.</li>\n<li>Oral <span class=\"customMeta\" data-dictid=\"8784b5a7ad16927772005323b514b8\">tetracycline</span> as <span class=\"customMeta\" data-dictid=\"bc36e9b9381692777196b5f9a2f79c\">prophylaxis</span> in <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> cases, especially with <span class=\"customMeta\" data-dictid=\"8b61bc6e361692777180695ac33e91\">acne</span> <span class=\"customMeta\" data-dictid=\"65c199df6316927771976629902acc\">rosacea</span> or seborrhoeic dermatitis.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/oKV1svnA6F3iH357B3m31747237088.mp3", "video": ""}, {"text": "Which is the most common organism causing bacterial blepharitis?", "options": [{"label": "A", "text": "Staphylococci", "correct": true}, {"label": "B", "text": "Streptococci", "correct": false}, {"label": "C", "text": "Propionibacterium acnes", "correct": false}, {"label": "D", "text": "Moraxella", "correct": false}], "correct_answer": "A. Staphylococci", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chronic infection of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> part of the lid margin</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Synonyms </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> blepharitis</li>\n<li>Staphylococcal blepharitis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causative Organisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Most commonly <span class=\"customMeta\" data-dictid=\"0520f732541692777199acffcfd9ba\">Staphylococci</span> (coagulase positive)</strong></li>\n<li>Rarely Streptococci, <span class=\"customMeta\" data-dictid=\"77ba04808316927771963f119df5a5\">Propionibacterium</span> acnes, and Moraxella</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic irritation</li>\n<li>Itching</li>\n<li>Mild lacrimation</li>\n<li>Gluing of cilia</li>\n<li>Mild photophobia</li>\n<li>Yellow crusts at the root of cilia</li>\n<li>Small ulcers that bleed easily when crusts are removed</li>\n<li>Red, thickened lid margins with dilated blood vessels</li>\n<li>Mild <span class=\"customMeta\" data-dictid=\"62b9af909d1692777194cd004f10f4\">papillary</span> <span class=\"customMeta\" data-dictid=\"6ce77d5f5e1692777185cf7f8a67cd\">conjunctivitis</span> and conjunctival hyperemia</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lid Hygiene:\n\t\t\t\t<ul>\n<li>Warm compresses</li>\n<li>Cotton buds dipped in <span class=\"customMeta\" data-dictid=\"e63a499e5716927771860681cef17d\">dilute</span> baby shampoo or 3% sodium <span class=\"customMeta\" data-dictid=\"2311c3b4ac16927771831d4c919043\">bicarbonate</span> solution</li>\n<li>Avoid touching</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li>Antibiotics</li>\n<li>Topical Steroids</li>\n<li>Ocular Lubricants</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6fYCv1m4ACBTDYkqmaiY1747645696.mp3", "video": ""}, {"text": "A 3-year-old girl has been having difficulty opening her left eye since birth. An image is given below. What is the condition?", "options": [{"label": "A", "text": "Symblepharon", "correct": false}, {"label": "B", "text": "Ankyloblepharon", "correct": true}, {"label": "C", "text": "Blepharitis", "correct": false}, {"label": "D", "text": "Blepharophimosis", "correct": false}], "correct_answer": "B. Ankyloblepharon", "question_images": ["https://image.prepladder.com/notes/jRN9PkrWGYsOBaMkGzGe1743665970.png"], "explanation_images": ["https://image.prepladder.com/notes/iyuzJK3MWDHkldIl9MDT1743666007.png", "https://image.prepladder.com/notes/jRN9PkrWGYsOBaMkGzGe1743665970.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:710px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Condition</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Definition</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Etiology</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symblepharon<img alt=\"OP282\" data-author=\"\" data-hash=\"6889\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/iyuzJK3MWDHkldIl9MDT1743666007.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Palpebral and <span class=\"customMeta\" data-dictid=\"ef00544aba1692777183bc916b1c30\">bulbar</span> <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> adhesions.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Healing of raw surfaces on the palpebral and <span class=\"customMeta\" data-dictid=\"ef00544aba1692777183bc916b1c30\">bulbar</span> conjunctiva.</li>\n<li>Causes: <span class=\"customMeta\" data-dictid=\"e316517c941692777200eb2671128d\">Thermal</span> or chemical burns, membranous conjunctivitis, injuries, conjunctival ulcerations, <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> pemphigus, Stevens-Johnson syndrome.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ankyloblepharon</strong><img alt=\"OP281\" data-author=\"\" data-hash=\"6888\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/jRN9PkrWGYsOBaMkGzGe1743665970.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adhesions between the margins of the upper and lower eyelids.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Congenital anomaly.</strong></li>\n<li>Acquired adhesions after <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> of chemical burns, <span class=\"customMeta\" data-dictid=\"e316517c941692777200eb2671128d\">thermal</span> burns, ulcers, and <span class=\"customMeta\" data-dictid=\"18034e0517169277720002aaa66d36\">traumatic</span> wounds of the lid margins.</li>\n<li>Often associated with symblepharon.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gsIvu80jTn8mSuCxyK231747645438.mp3", "video": ""}, {"text": "A 45-year-old woman with hypothyroidism is now complaining of loss of eyelashes. What is the diagnosis?", "options": [{"label": "A", "text": "Madarosis", "correct": true}, {"label": "B", "text": "Poliosis", "correct": false}, {"label": "C", "text": "Tylosis", "correct": false}, {"label": "D", "text": "Trichiasis", "correct": false}], "correct_answer": "A. Madarosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/gBMtGpCUjEGNb7Y5RT561743665827.png", "https://image.prepladder.com/notes/L3T9YCtYKHyIcSlOZhNZ1743665863.png", "https://image.prepladder.com/notes/FEvT0Mkpq8iNoWHQO7iz1743665892.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Condition</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Definition</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Local Causes</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Systemic Causes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Madarosis</strong><strong> (Option A)</strong></p>\n<br/>\n<img alt=\"OP278\" data-author=\"\" data-hash=\"6884\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/gBMtGpCUjEGNb7Y5RT561743665827.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Partial or complete loss of eyelashes or eyebrows.</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic blepharitis</li>\n<li>Cicatrizing conjunctivitis</li>\n<li>Complications from cryotherapy, radiotherapy, or surgery for <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> lesions</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Alopecia</li>\n<li>Psoriasis</li>\n<li><strong>Hypothyroidism</strong></li>\n<li>Leprosy</li>\n<li>Systemic <span class=\"customMeta\" data-dictid=\"ccd536a9071692777191f53538ca30\">lupus</span> erythematosus</li>\n<li>Acquired syphilis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Poliosis (Option B)</strong></p>\n<p><img alt=\"OP279\" data-author=\"\" data-hash=\"6885\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/L3T9YCtYKHyIcSlOZhNZ1743665863.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Greying of eyelashes and eyebrows.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chronic <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> blepharitis</li>\n<li>Sympathetic ophthalmitis</li>\n<li>Idiopathic uveitis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Vogt-Koyanagi-Harada syndrome</li>\n<li>Waardenburg syndrome</li>\n<li>Vitiligo</li>\n<li>Marfan syndrome</li>\n<li>Tuberous sclerosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/I3snrO8jNiIzbrBOnLmG1747645095.mp3", "video": ""}, {"text": "A neonatologist has noted the following finding in a newborn baby. What is the condition called?", "options": [{"label": "A", "text": "Trichiasis", "correct": false}, {"label": "B", "text": "Pseudotrichiasis", "correct": false}, {"label": "C", "text": "Distichiasis", "correct": true}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "C. Distichiasis", "question_images": ["https://image.prepladder.com/notes/hoCya67dw3npK51NfHWY1743665686.png"], "explanation_images": ["https://image.prepladder.com/notes/gIeC2JNkOEtYtnhaR6eC1743665748.png", "https://image.prepladder.com/notes/hoCya67dw3npK51NfHWY1743665686.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clinical features</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Foreign body sensation</li>\n<li>Photophobia</li>\n<li>Irritation</li>\n<li>Pain</li>\n<li>Lacrimation</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"540b75eeb516927771831794d7ce0f\">blepharospasm</span> and <span class=\"customMeta\" data-dictid=\"46e2a1c298169277719583f46ff587\">photophobia</span> (if the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is abraded)</li>\n<li>Conjunctival congestion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Complications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Recurrent corneal abrasions</li>\n<li>Superficial corneal opacities</li>\n<li>Corneal vascularization</li>\n</ul>\n<ul>\n<li>Non-healing corneal ulcer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Epilation</li>\n<li>Electrolysis</li>\n<li>Cryoepilation</li>\n<li>Surgical correction</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CAABSrJQXl0nSOKxTVUH1747644795.mp3", "video": ""}, {"text": "A 70-year-old patient presents with complaints of epiphora. On examination, there is an eversion of the punctum noted. Which among the following is incorrect regarding the type of ectropion seen in this patient?", "options": [{"label": "A", "text": "Most common type of ectropion", "correct": false}, {"label": "B", "text": "Can cause lagophthalmos", "correct": false}, {"label": "C", "text": "Age-related changes are implicated in etiopathogenesis", "correct": false}, {"label": "D", "text": "Starts from lateral eyelid and progresses medially", "correct": true}], "correct_answer": "D. Starts from lateral eyelid and progresses medially", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:648px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Involutional Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Most common; age-related</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Horizontal laxity</li>\n<li>Canthal <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">tendon</span> laxity</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Epiphora</li>\n<li>Tarsal thinning</li>\n<li>Lagophthalmos</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Medial <span class=\"customMeta\" data-dictid=\"08ad217507169277718520a894eb90\">conjunctivoplasty</span> for mild cases.</li>\n<li>Horizontal lid shortening for moderate cases.</li>\n<li><strong>Byron Smith's modified Kuhnt-Szymanowski operation</strong> for severe cases.</li>\n<li>Lateral <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> strip technique for generalized ectropion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cicatricial Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Scarring of <strong>anterior </strong>lamella</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Trauma/surgery</li>\n<li>Scarring conditions (e.g., blepharitis)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Scarring</li>\n<li>Skin fibrosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mild cases: V-Y operation.</li>\n<li>Mild to moderate cases: Z-plasty (Elschnig's operation).</li>\n<li>Severe cases: <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">Excision</span> of <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> tissue and full-thickness skin grafting.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Paralytic Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Facial nerve <span class=\"customMeta\" data-dictid=\"f3e67cebd51692777194f5257898e4\">palsy</span> (Bell’s)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Bell’s palsy</strong></li>\n<li>Trauma/surgery</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Exposure keratopathy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Temporary measures: <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">Topical</span> lubricants, <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> taping, <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> tarsorrhaphy.</li>\n<li>Permanent measures (if needed): <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">Horizontal</span> lid tightening with/without middle <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> buttress, palpebral <span class=\"customMeta\" data-dictid=\"5e2a7b127c1692777198f4895cc7c0\">sling</span> operation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mechanical Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mass or <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> pushing eyelid</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tumors</li>\n<li>Conjunctival growths</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Eyelid displacement</li>\n<li>Conjunctival chemosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Treat the underlying mechanical causes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Congenital Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Present at birth</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tarsal plate atrophy</li>\n<li><strong>Down syndrome</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Associated <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> malformation</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Mild cases may not require treatment.</li>\n<li>Moderate or severe cases: <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">Horizontal</span> lid tightening and full-thickness skin graft.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>GRADE</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>FEATURE</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>0</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> appearance and function</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Only <span class=\"customMeta\" data-dictid=\"4ce248062516927771965f55d1bf0a\">punctum</span> is everted</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>II</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lid margin everted and palpebral <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> visible</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>III</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Fornix is also visible</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XgMKaVHVi9l4abEXbGJt1747644514.mp3", "video": ""}, {"text": "Match the following types of entropion with their correct pair 1) Mechanical entropion A) Trachoma 2) Cicatricial entropion B) Phthisis bulbi 3) Congenital entropion C) Senile entropion 4) Involutional entropion D) Most commonly involves lower eyelid", "options": [{"label": "A", "text": "1-A, 2-B, 3-C, 4-D", "correct": false}, {"label": "B", "text": "1-C, 2-A, 3-B, 4-D", "correct": false}, {"label": "C", "text": "1-B, 2-A, 3-D, 4-C", "correct": true}, {"label": "D", "text": "1-B, 2-A, 3-C, 4-D", "correct": false}], "correct_answer": "C. 1-B, 2-A, 3-D, 4-C", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1) Mechanical entropion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>B) <span class=\"customMeta\" data-dictid=\"6317e2568716927771953af05b1dae\">Phthisis</span> bulbi</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2) <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">Cicatricial</span> entropion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A) Trachoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3) <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> entropion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>D) Most commonly involves lower eyelid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4) <span class=\"customMeta\" data-dictid=\"0ba7903b731692777190bade45b8b5\">Involutional</span> entropion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>C) <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> entropion</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1) <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">Congenital</span> Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present since birth, more common in the<strong> lower <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lower Eyelid: Improper development of lower lid retractors.</li>\n<li>Upper Eyelid: Mechanical effects due to microphthalmos.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2) <span class=\"customMeta\" data-dictid=\"315587fa991692777184026693ef7f\">Cicatricial</span> Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Commonly involves the <strong>upper eyelid.</strong></p>\n<br/>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Common causes: <strong>Trachoma</strong>, chemical burns, pemphigus, Stevens-Johnson syndrome, symblepharon.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3) <span class=\"customMeta\" data-dictid=\"f13bb39af816927771989e731b0502\">Senile</span> (Involutional) Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Affects the <strong>lower <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> in elderly individuals</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Horizontal lid laxity</strong></li>\n<li>Vertical lid instability</li>\n<li>Overriding of <span class=\"customMeta\" data-dictid=\"9bb60465b21692777196a02e5ce788\">pretarsal</span> orbicularis.</li>\n<li>Laxity of <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4) Mechanical Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lack of support from the globe to the lids.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Occurs in conditions like <strong>phthisis bulbi</strong>, <span class=\"customMeta\" data-dictid=\"1f51f462bc1692777187ffc9d3094b\">enophthalmos</span> and after <span class=\"customMeta\" data-dictid=\"c4ed8e6ddb169277718796a1728b51\">enucleation</span> or <span class=\"customMeta\" data-dictid=\"00fc1a6b38169277718780d2bc69d1\">evisceration</span> operations.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zOCpEF98fW7X0IXNaIKl1747644134.mp3", "video": ""}, {"text": "A 75-year-old male patient presents with the following ocular findings and complaints of watering and photophobia. On examination, there are signs of minimal horizontal lid laxity. Which of the following surgical procedures would be the most appropriate for a long-term correction of his condition?", "options": [{"label": "A", "text": "Transverse sutures", "correct": false}, {"label": "B", "text": "Weis procedure", "correct": true}, {"label": "C", "text": "Jones operation", "correct": false}, {"label": "D", "text": "Quickert procedure", "correct": false}], "correct_answer": "B. Weis procedure", "question_images": ["https://image.prepladder.com/notes/nnB8wETMFhJcnnLoj3071743665267.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:617px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Description and etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Usually seen in lower <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> in elderly people</li>\n<li>Horizontal lid <span class=\"customMeta\" data-dictid=\"6f158cd2c11692777191fbc6ef31ac\">laxity</span> due to weakening of orbicularis muscle</li>\n<li>Vertical lid <span class=\"customMeta\" data-dictid=\"acb259200b16927771908888d1377c\">instability</span> due to weakening of capsulopalpebral fascia</li>\n<li>Overriding of <span class=\"customMeta\" data-dictid=\"9bb60465b21692777196a02e5ce788\">pretarsal</span> orbicularis/Laxity of <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Foreign body sensation</li>\n<li>Lacrimation</li>\n<li>Photophobia</li>\n<li>Horizontal lid laxity</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Surgical Techniques</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>i. <strong>Transverse Suture and Everting Suture:</strong> <strong>(Option A)</strong></p>\n<ul>\n<li>Temporary cure (up to 18 months)</li>\n<li>Suitable for very old patients</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>ii. <strong>Weis procedure:</strong> <strong>(Option B)</strong></p>\n<ul>\n<li>Long-term cure with minimal <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> lid laxity</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>iii. <strong>Plication of Lower Lid Retractors (Jones Operation):</strong> <strong>(Option C)</strong></p>\n<ul>\n<li>Used in severe cases or after recurrence</li>\n<li>Shortens lower lid retractors.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>iv. <strong>Quickert Procedure:</strong> <strong> (Option D)</strong></p>\n<ul>\n<li>For cases with marked <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> lid laxity</li>\n<li>Combines <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> lid shortening with Weis procedure</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:619px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Grade-I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Only the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> lid border is in-rolled</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Grade-II</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>includes in-rolling up to the intermarginal strip</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Grade-III</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Whole lid margin including the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> border is in-rolled</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/T1DTGZAdsgaKwzRh7PTP1747643934.mp3", "video": ""}, {"text": "Which among the following structures is part of the anterior lamella of the eyelid?", "options": [{"label": "A", "text": "Orbicularis oculi", "correct": true}, {"label": "B", "text": "Orbital septum", "correct": false}, {"label": "C", "text": "Tarsal plate", "correct": false}, {"label": "D", "text": "Conjunctiva", "correct": false}], "correct_answer": "A. Orbicularis oculi", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/uqaE9Rc4Fkc0Eq73G8EF1743664541.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mvWTfT6atkMuqp7WHaiL1747640183.mp3", "video": ""}, {"text": "All are causes of ipsilateral pseudoptosis except", "options": [{"label": "A", "text": "Enophthalmos", "correct": false}, {"label": "B", "text": "Lid retraction", "correct": true}, {"label": "C", "text": "Hypotropia", "correct": false}, {"label": "D", "text": "Phthisis bulbi", "correct": false}], "correct_answer": "B. Lid retraction", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ipsilateral pseudoptosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Contralateral pseudoptosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Microphthalmos</li>\n<li>Enophthalmos <strong>(Option A)</strong></li>\n<li>Phthisis <span class=\"customMeta\" data-dictid=\"7be1c27a4f16927771831ce746bc8e\">bulbi</span> <strong>(Option D)</strong></li>\n<li>Hypotropia <strong>(Option C)</strong></li>\n<li>Dermatochalasis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Eyelid <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> <strong>(Option B)</strong></li>\n<li>High myopia</li>\n<li>Proptosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/iIFS9XVoM2Ff2w1UUOUQ1747642959.mp3", "video": ""}, {"text": "Which of the following measurements is considered indicative of moderate ptosis?", "options": [{"label": "A", "text": "1 mm droop", "correct": false}, {"label": "B", "text": "2 mm droop", "correct": false}, {"label": "C", "text": "3 mm droop", "correct": true}, {"label": "D", "text": "4 mm droop", "correct": false}], "correct_answer": "C. 3 mm droop", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/fXIzRUCLijrti7HkrVcw1743664841.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:377px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild Ptosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2mm droop</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate Ptosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3mm droop</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe Ptosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4mm droop</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WKXALWyObPHt1hxQKJhu1747642408.mp3", "video": ""}, {"text": "Which muscle is most commonly affected in congenital ptosis?", "options": [{"label": "A", "text": "Orbicularis oculi", "correct": false}, {"label": "B", "text": "Levator palpebrae superioris", "correct": true}, {"label": "C", "text": "Frontalis", "correct": false}, {"label": "D", "text": "Superior oblique", "correct": false}], "correct_answer": "B. Levator palpebrae superioris", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/MMUhNjOVZOUivBFGAwBm1743664787.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wMJUhqUF3yl1B0KMbNPc1747642265.mp3", "video": ""}, {"text": "Which of the following is a distinguishing feature of aponeurotic ptosis compared to other forms of ptosis?", "options": [{"label": "A", "text": "Accompanied by ocular motor dysfunction", "correct": false}, {"label": "B", "text": "Presents with normal function of the levator muscle", "correct": true}, {"label": "C", "text": "Results from a neurological condition affecting the third cranial nerve", "correct": false}, {"label": "D", "text": "Usually involves a sudden onset of symptoms", "correct": false}], "correct_answer": "B. Presents with normal function of the levator muscle", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KkRPEigpocFfyOQmvz2X1747642612.mp3", "video": ""}, {"text": "A 45-year-old female presents with bilateral ptosis that worsens throughout the day, particularly in the evening, and improves with rest. She also complains of double vision and generalized fatigue. Which of the following is the most likely cause of her symptoms?", "options": [{"label": "A", "text": "Horner's Syndrome", "correct": false}, {"label": "B", "text": "Myasthenia Gravis", "correct": true}, {"label": "C", "text": "Oculopharyngeal Muscular Dystrophy", "correct": false}, {"label": "D", "text": "Botulism", "correct": false}], "correct_answer": "B. Myasthenia Gravis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/M0gApeuJx6rfXfYMixgl1747641745.mp3", "video": ""}, {"text": "A 60-year old male, heavy smoker, presents with persistent shoulder pain radiating to arm for several months. He presents with the following ocular findings. A chest x-ray reveals mass at the apex of the left lung. Which of the following symptoms is most likely to accompany this patient?", "options": [{"label": "A", "text": "Mydriasis", "correct": false}, {"label": "B", "text": "Contralateral ptosis", "correct": false}, {"label": "C", "text": "Anhydrosis and miosis", "correct": true}, {"label": "D", "text": "Ophthalmoplegia", "correct": false}], "correct_answer": "C. Anhydrosis and miosis", "question_images": ["https://image.prepladder.com/notes/XHZUIFFhNl9lleBitr3G1743664708.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/brOu7fuSk2NGhMealpg31747641443.mp3", "video": ""}, {"text": "Identify the structure marked ‘X’ in the given image.", "options": [{"label": "A", "text": "Orbicularis oculi muscle", "correct": false}, {"label": "B", "text": "Tarsal plate", "correct": true}, {"label": "C", "text": "Palpebral conjunctiva", "correct": false}, {"label": "D", "text": "Levator aponeurosis", "correct": false}], "correct_answer": "B. Tarsal plate", "question_images": ["https://image.prepladder.com/notes/N5q9MfmjX9h4f6hV9Wsx1743664593.png"], "explanation_images": ["https://image.prepladder.com/notes/Jqskue1BXxf7EJoWddu11743664637.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anterior lamella</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior lamella</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Skin</li>\n<li>Subcutaneous tissue</li>\n<li>Orbicularis oculi</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tarsal plate</li>\n<li>Conjunctiva</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yGxP4NyB1wsvWRyBGNZo1748325803.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 27 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which muscle is implicated in ptosis in Horner syndrome?", "options": [{"label": "A", "text": "Müller muscle", "correct": true}, {"label": "B", "text": "Levator aponeurosis", "correct": false}, {"label": "C", "text": "Horner muscle", "correct": false}, {"label": "D", "text": "Orbicularis oculi", "correct": false}], "correct_answer": "A. Müller muscle", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Müller mu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the recommended treatment for a patient with Bell's palsy, who is experiencing symptoms of dry eye, redness, and irritation, along with the presence of multiple punctate epithelial erosions in the cornea as observed through a slit lamp examination?", "options": [{"label": "A", "text": "Tarsorrhaphy", "correct": true}, {"label": "B", "text": "Contact lens", "correct": false}, {"label": "C", "text": "Corneal replacement", "correct": false}, {"label": "D", "text": "LASIK", "correct": false}], "correct_answer": "A. Tarsorrhaphy", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Tarsorrhaph\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the instrument.", "options": [{"label": "A", "text": "Evisceration spatula", "correct": false}, {"label": "B", "text": "Chalazion clamp", "correct": true}, {"label": "C", "text": "Enucleation spoon", "correct": false}, {"label": "D", "text": "Bone punch", "correct": false}], "correct_answer": "B. Chalazion clamp", "question_images": ["https://image.prepladder.com/notes/Ea1Zsr27FWeGv4Mkrrjx1747985557.png"], "explanation_images": ["https://image.prepladder.com/content/TPdDiJqCIxhFs7LT6ocU1746700809.png"], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"3f62f9a1931692777184416b7a5d06\"&gt;Chalazion&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the term for the additional row of eyelashes located behind the grey line?", "options": [{"label": "A", "text": "Trichiasis", "correct": false}, {"label": "B", "text": "Distichiasis", "correct": true}, {"label": "C", "text": "Tylosis", "correct": false}, {"label": "D", "text": "Madarosis", "correct": false}], "correct_answer": "B. Distichiasis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/8qoIAkYHwY3AsVqREvlF1746516880.png", "https://image.prepladder.com/content/6L4EcmScYFMjzf5IMh111746516880.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Clinical features</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Foreign body sensation</li>\n<li>Photophobia</li>\n<li>Irritation</li>\n<li>Pain</li>\n<li>Lacrimation</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"540b75eeb516927771831794d7ce0f\">blepharospasm</span> and <span class=\"customMeta\" data-dictid=\"46e2a1c298169277719583f46ff587\">photophobia</span> (if the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is abraded)</li>\n<li>Conjunctival congestion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Complications</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Recurrent corneal abrasions</li>\n<li>Superficial corneal opacities</li>\n<li>Corneal vascularization</li>\n</ul>\n<ul>\n<li>Non-healing corneal ulcer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Treatment</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Epilation</li>\n<li>Electrolysis</li>\n<li>Cryoepilation</li>\n<li>Surgical correction</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most frequently occurring tumor found in the lacrimal gland?", "options": [{"label": "A", "text": "Adenoid cystic carcinoma", "correct": false}, {"label": "B", "text": "Lymphoma", "correct": false}, {"label": "C", "text": "Pleomorphic adenoma", "correct": true}, {"label": "D", "text": "Mucoepidermoid carcinoma", "correct": false}], "correct_answer": "C. Pleomorphic adenoma", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tumor of <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> (Overall/ Benign)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pleomorphic <span class=\"customMeta\" data-dictid=\"c3c9726266169277718021f4f0fa16\">adenoma</span> </strong><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant tumor of <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">Lacrimal</span> gland</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adenoid <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> &gt; <span class=\"customMeta\" data-dictid=\"bfe880c97416927771936bbfc7d7ec\">Mucoepidermoid</span> carcinoma</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Benign <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> tumor - Adults</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cavernous hemangioma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> tumor - Adults</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lymphoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Benign <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> tumor - Children</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dermoid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> tumor - Children</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rhabdomyosarcoma</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An 11-month-old baby was brought by his mother with complaints of the left upper eyelid moving up and down while breastfeeding that disappears when the baby is not breastfeeding. She gave a history of the child being diagnosed with left eye ptosis. What is this condition called?", "options": [{"label": "A", "text": "Symblepharon", "correct": false}, {"label": "B", "text": "Blepharophimosis syndrome", "correct": false}, {"label": "C", "text": "Lagophthalmos", "correct": false}, {"label": "D", "text": "Marcus -Gunn jaw-winking", "correct": true}], "correct_answer": "D. Marcus -Gunn jaw-winking", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/mb9JUOZCjWjv72pxiz0h1747905777.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the context of medical treatment, the V-Y procedure is employed for which of the subsequent conditions?", "options": [{"label": "A", "text": "Entropion", "correct": false}, {"label": "B", "text": "Ectropion", "correct": true}, {"label": "C", "text": "Blepharophimosis", "correct": false}, {"label": "D", "text": "Ptosis", "correct": false}], "correct_answer": "B. Ectropion", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:648px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Type of Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Involutional Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Most common; age-related</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Horizontal laxity</li>\n<li>Canthal <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">tendon</span> laxity</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Epiphora</li>\n<li>Tarsal thinning</li>\n<li>Lagophthalmos</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Medial <span class=\"customMeta\" data-dictid=\"08ad217507169277718520a894eb90\">conjunctivoplasty</span> for mild cases.</li>\n<li>Horizontal lid shortening for moderate cases.</li>\n<li><strong>Byron Smith's modified Kuhnt-Szymanowski operation</strong> for severe cases.</li>\n<li>Lateral <span class=\"customMeta\" data-dictid=\"b07a8f84ed1692777200d49cca6177\">tarsal</span> strip technique for generalized ectropion.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cicatricial Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Scarring of <strong>anterior </strong>lamella</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Trauma/surgery</li>\n<li>Scarring conditions (e.g., blepharitis)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Scarring</li>\n<li>Skin fibrosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mild cases: <strong>V-Y operation. (Option B)</strong></li>\n<li>Mild to moderate cases: Z-plasty (Elschnig's operation).</li>\n<li>Severe cases: <span class=\"customMeta\" data-dictid=\"20b3ce06c5169277718756ee95c1e9\">Excision</span> of <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> tissue and full-thickness skin grafting.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Paralytic Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Facial nerve <span class=\"customMeta\" data-dictid=\"f3e67cebd51692777194f5257898e4\">palsy</span> (Bell’s)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Bell’s palsy</strong></li>\n<li>Trauma/surgery</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Exposure keratopathy</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Temporary measures: <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">Topical</span> lubricants, <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> taping, <span class=\"customMeta\" data-dictid=\"90dcd6e02316927771990a5c253ff7\">suture</span> tarsorrhaphy.</li>\n<li>Permanent measures (if needed): <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">Horizontal</span> lid tightening with/without middle <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">lamellar</span> buttress, palpebral <span class=\"customMeta\" data-dictid=\"5e2a7b127c1692777198f4895cc7c0\">sling</span> operation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanical Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mass or <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> pushing eyelid</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Tumors</li>\n<li>Conjunctival growths</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Eyelid displacement</li>\n<li>Conjunctival chemosis</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Treat the underlying mechanical causes.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Congenital Ectropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Present at birth</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Tarsal plate atrophy</li>\n<li><strong>Down syndrome</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Associated <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> malformation</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mild cases may not require treatment.</li>\n<li>Moderate or severe cases: <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">Horizontal</span> lid tightening and full-thickness skin graft.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please identify the medical condition depicted in the provided image.", "options": [{"label": "A", "text": "Entropion", "correct": true}, {"label": "B", "text": "Ectropion", "correct": false}, {"label": "C", "text": "Trichiasis", "correct": false}, {"label": "D", "text": "Ptosis", "correct": false}], "correct_answer": "A. Entropion", "question_images": ["https://image.prepladder.com/content/hrnLcv9NVI10vywfo4w41745925232.png"], "explanation_images": ["https://image.prepladder.com/content/sl1ueFh2OqziUaBLbi7q1745925278.png", "https://image.prepladder.com/content/ZhZmzEj5tSPnHAJcaE6G1745925278.png", "https://image.prepladder.com/content/GjnBF8Y1XvuuoQfght8G1745925278.png", "https://image.prepladder.com/content/9zY0qbbIfDMOtodDq9MG1745925278.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:619px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Grade-I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Only the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> lid border is in-rolled</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Grade-II</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>includes in-rolling up to the intermarginal strip</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Grade-III</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Whole lid margin including the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> border is in-rolled</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:623px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>1) Congenital Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Present since birth, more common in the<strong> lower <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Lower Eyelid: Improper development of lower lid retractors.</li>\n<li>Upper Eyelid: Mechanical effects due to microphthalmos.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>2) Cicatricial Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Commonly involves the <strong>upper eyelid.</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Common causes: <strong>Trachoma</strong>, chemical burns, pemphigus, Stevens-Johnson syndrome, symblepharon.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>3) Senile (Involutional) Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Affects the <strong>lower <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> in elderly individuals</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Horizontal lid laxity</strong></li>\n<li>Vertical lid instability</li>\n<li>Overriding of <span class=\"customMeta\" data-dictid=\"9bb60465b21692777196a02e5ce788\">pretarsal</span> orbicularis.</li>\n<li>Laxity of <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>4) Mechanical Entropion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lack of support from the globe to the lids.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Occurs in conditions like <strong>phthisis bulbi</strong>, <span class=\"customMeta\" data-dictid=\"1f51f462bc1692777187ffc9d3094b\">enophthalmos</span> and after <span class=\"customMeta\" data-dictid=\"c4ed8e6ddb169277718796a1728b51\">enucleation</span> or <span class=\"customMeta\" data-dictid=\"00fc1a6b38169277718780d2bc69d1\">evisceration</span> operations.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following are features of oculomotor nerve palsy except?", "options": [{"label": "A", "text": "Exotropia", "correct": false}, {"label": "B", "text": "Dilated pupil", "correct": false}, {"label": "C", "text": "Limited Abduction", "correct": true}, {"label": "D", "text": "Ptosis", "correct": false}], "correct_answer": "C. Limited Abduction", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Limited abdu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following are functions of superior oblique muscle except?", "options": [{"label": "A", "text": "Adduction", "correct": true}, {"label": "B", "text": "Abduction", "correct": false}, {"label": "C", "text": "Depression", "correct": false}, {"label": "D", "text": "Intorsion", "correct": false}], "correct_answer": "A. Adduction", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/bUqlgC908gaW9sVxei1W1748279889.png"], "explanation": "<table>\n<thead>\n<tr>\n<th><strong>Muscle</strong></th>\n<th><strong>Primary Actions</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>Superior oblique</td>\n<td>Abduction, depression (in adducted eye), intorsion</td>\n</tr>\n<tr>\n<td>Inferior oblique</td>\n<td>Abduction, <span class=\"customMeta\" data-dictid=\"a1f256489a16927771870ddd296574\">elevation</span> (in adducted eye), extorsion</td>\n</tr>\n<tr>\n<td>Medial rectus</td>\n<td>Adduction</td>\n</tr>\n<tr>\n<td>Lateral rectus</td>\n<td>Abduction</td>\n</tr>\n<tr>\n<td>Superior rectus</td>\n<td>Elevation (in abducted eye), intorsion, slight adduction</td>\n</tr>\n<tr>\n<td>Inferior rectus</td>\n<td>Depression (in abducted eye), extorsion, slight adduction</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the order of insertion of muscles on Annulus of Zinn? A. Medial rectus B. Inferior rectus C. Lateral rectus D. Superior rectus", "options": [{"label": "A", "text": "A, B, C, D", "correct": true}, {"label": "B", "text": "B, C, A, D", "correct": false}, {"label": "C", "text": "D, C, A, B", "correct": false}, {"label": "D", "text": "C, A, B, D", "correct": false}], "correct_answer": "A. A, B, C, D", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/dLWVDxW2XhLlV8IUE4111747655869.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:718px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Origin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Insertion </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Nerve supply</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Recti </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Common <span class=\"customMeta\" data-dictid=\"96f5104d6816927771816ac8dfceeb\">annular</span> <span class=\"customMeta\" data-dictid=\"606c2acae5169277720052151cb04c\">tendon</span> or <span class=\"customMeta\" data-dictid=\"33613b8eda1692777200cd66184ed6\">tendinous</span> ring of Zinn.</p>\n<p>(all recti have the same origin)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Sclera little <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> to the <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">limbus</span> (corneoscleral junction)</p>\n<p> </p>\n<p>The average distance from <span class=\"customMeta\" data-dictid=\"799979f3bc169277719134cd535c7c\">Limbus</span> is:</p>\n<ul>\n<li>Superior: 7.7 mm</li>\n<li>Inferior: 6.5 mm</li>\n<li>Medial: 5.5 mm</li>\n<li>Lateral: 6.9 mm</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Superior oblique: <strong>Trochlear nerve</strong></li>\n<li>Lateral rectus: <strong>Abducens nerve</strong></li>\n<li>Rest all other recti: <strong>Oculomotor nerve</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 3-month-old child was brought to the outpatient department (OPD) with symptoms of photophobia and watering of the eyes. Which of the following is not a cause of this condition?", "options": [{"label": "A", "text": "Congenital nasolacrimal duct obstruction B) Congenital entropion C) Congenital glaucoma D) Congenital distichiasis", "correct": false}, {"label": "B", "text": "Congenital entropion", "correct": false}, {"label": "C", "text": "Congenital glaucoma", "correct": false}, {"label": "D", "text": "Congenital distichiasis", "correct": true}], "correct_answer": "D. Congenital distichiasis", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/OVPSfugEyqrC0IAbT5k71741277277.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clinical features</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Foreign body sensation</li>\n<li>Photophobia, in cases of corneal irritation</li>\n<li>Irritation</li>\n<li>Pain</li>\n<li>Lacrimation, in cases of corneal irritation</li>\n<li>Reflex <span class=\"customMeta\" data-dictid=\"540b75eeb516927771831794d7ce0f\">blepharospasm</span> and <span class=\"customMeta\" data-dictid=\"46e2a1c298169277719583f46ff587\">photophobia</span> (if the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> is abraded)</li>\n<li>Conjunctival congestion</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Complications</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Recurrent corneal abrasions</li>\n<li>Superficial corneal opacities</li>\n<li>Corneal vascularization</li>\n</ul>\n<ul>\n<li>Non-healing corneal ulcer</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Epilation</li>\n<li>Electrolysis</li>\n<li>Cryoepilation</li>\n<li>Surgical correction</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis for a patient who has a painless, firm nodule on the upper eyelid that is growing away from the lid margin?", "options": [{"label": "A", "text": "Stye", "correct": false}, {"label": "B", "text": "Entropion", "correct": false}, {"label": "C", "text": "Chalazion", "correct": true}, {"label": "D", "text": "Blepharitis", "correct": false}], "correct_answer": "C. Chalazion", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/CSgtEAe55U1HMSbjJ5HQ1715249154.JPG"], "explanation": "<p>Correct Option C - Ch\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a patient presenting with recurrent chalazion, which cancer should be suspected?", "options": [{"label": "A", "text": "Sebaceous cell carcinoma", "correct": true}, {"label": "B", "text": "Squamous cell carcinoma", "correct": false}, {"label": "C", "text": "Basal cell carcinoma", "correct": false}, {"label": "D", "text": "Kaposi’s sarcoma", "correct": false}], "correct_answer": "A. Sebaceous cell carcinoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"359edf0778169277719886070af9db\"&gt;Sebaceous&lt;/span&gt; cell &lt;span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\"&gt;carcinoma&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Internal hordeolum is due to inflammation of", "options": [{"label": "A", "text": "Zeis glands", "correct": false}, {"label": "B", "text": "Meibomian glands", "correct": true}, {"label": "C", "text": "Lacrimal glands", "correct": false}, {"label": "D", "text": "Moll glands", "correct": false}], "correct_answer": "B. Meibomian glands", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/uJh7qjfagzPUaKCwhwsU1715343882.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is characterized by chronic granulomatous inflammation in the upper eyelid, causing painless swelling?", "options": [{"label": "A", "text": "Internal hordeolum", "correct": false}, {"label": "B", "text": "External hordeolum", "correct": false}, {"label": "C", "text": "Chalazion", "correct": true}, {"label": "D", "text": "Trachoma", "correct": false}], "correct_answer": "C. Chalazion", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/npwxIsbr547Zb6KVXtqJ1715662666.png"], "explanation": "<p>Correct Option C - Chalazion: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the recommended course of treatment for mild congenital ptosis?", "options": [{"label": "A", "text": "Blaskowic’s operation", "correct": false}, {"label": "B", "text": "Everbusch’s operation", "correct": false}, {"label": "C", "text": "Fasanella-Servat operation", "correct": true}, {"label": "D", "text": "Frontalis Sling operation", "correct": false}], "correct_answer": "C. Fasanella-Servat operation", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Fasanella-Serv\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the appropriate treatment for ptosis resulting from Horner's syndrome?", "options": [{"label": "A", "text": "Blaskowic’s operation", "correct": false}, {"label": "B", "text": "Frontalis Sling operation", "correct": false}, {"label": "C", "text": "Fasanella servat operation", "correct": true}, {"label": "D", "text": "Everbusch’s operation", "correct": false}], "correct_answer": "C. Fasanella servat operation", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - Fasanella-Serv\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most frequently observed eye manifestation in this disease in a 45-year-old patient who presents with progressive weakness throughout the day and is found to possess antibodies against nicotinic acetylcholine receptors?", "options": [{"label": "A", "text": "Miosis", "correct": false}, {"label": "B", "text": "Lagophthalmos", "correct": false}, {"label": "C", "text": "Exophthalmos", "correct": false}, {"label": "D", "text": "Ptosis", "correct": true}], "correct_answer": "D. Ptosis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - P\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a case of long-standing, uncontrolled diabetes, what is the most common characteristic of third nerve palsy?", "options": [{"label": "A", "text": "Limited abduction", "correct": false}, {"label": "B", "text": "Pseudoptosis", "correct": false}, {"label": "C", "text": "Ptosis", "correct": true}, {"label": "D", "text": "Pupillary dysfunction", "correct": false}], "correct_answer": "C. Ptosis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - P\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 30 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following types of ocular injuries can result from blunt trauma to the eye? 1) 2) 3) 4)", "options": [{"label": "A", "text": "2 and 4", "correct": false}, {"label": "B", "text": "1 and 2", "correct": false}, {"label": "C", "text": "3 and 1", "correct": false}, {"label": "D", "text": "All of the Above", "correct": true}], "correct_answer": "D. All of the Above", "question_images": ["https://image.prepladder.com/notes/nsZ3HgcHF0gIi4iHgWgm1742987998.png", "https://image.prepladder.com/notes/kQNsB6SSztdafk9R4siw1742987999.png", "https://image.prepladder.com/notes/1aP2DF4cCfrpoD6EN5T91742987999.png", "https://image.prepladder.com/notes/3MSFWN7elQUB7cfV7z2C1742987999.png"], "explanation_images": ["https://image.prepladder.com/notes/nsZ3HgcHF0gIi4iHgWgm1742987998.png", "https://image.prepladder.com/notes/kQNsB6SSztdafk9R4siw1742987999.png", "https://image.prepladder.com/notes/1aP2DF4cCfrpoD6EN5T91742987999.png", "https://image.prepladder.com/notes/3MSFWN7elQUB7cfV7z2C1742987999.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:514px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Hyphema</li>\n</ol>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Imrankabirhossain\" data-hash=\"1879\" data-license=\"CC BY SA 3.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Total_hyphema.jpg\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/nsZ3HgcHF0gIi4iHgWgm1742987998.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> tear</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Papaioannou, Lamprini &amp; Papathanassiou, Miltiadis. \" data-hash=\"1880\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Extensive-descemets-membrane-rupture_fig1_313615891\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/kQNsB6SSztdafk9R4siw1742987999.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3. Vossius ring</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Klaeger, Andres &amp; Herbort, Carl.\" data-hash=\"1881\" data-license=\"NA\" data-source=\"https://www.researchgate.net/figure/Right-and-left-anterior-segment-after-the-anterior-uveitis-started-in-the-left-eye-A_fig2_23317095\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/1aP2DF4cCfrpoD6EN5T91742987999.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4. Lens subluxation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Chen, Tianhui &amp; Deng, Michael &amp; Zhang, Min &amp; Chen, Jiahui &amp; Chen, Zexu &amp; Jiang, Yongxiang. \" data-hash=\"1882\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/publication/349031986_Visual_outcomes_of_lens_subluxation_surgery_with_Cionni_modified_capsular_tension_rings_in_Marfan_syndrome\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/3MSFWN7elQUB7cfV7z2C1742987999.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OytSRoxULYUKpZF27NEK1747394196.mp3", "video": ""}, {"text": "A patient presents with a full-thickness corneal wound caused by a nail. Which of the following is the most likely complication if the injury is left untreated?", "options": [{"label": "A", "text": "Ring abscess of the cornea", "correct": true}, {"label": "B", "text": "Retinal detachment", "correct": false}, {"label": "C", "text": "Glaucoma", "correct": false}, {"label": "D", "text": "Strabismus", "correct": false}], "correct_answer": "A. Ring abscess of the cornea", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/SZiDOvyeysZ3mXfYjesN1742988864.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:611px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Penetrating Eye Injury</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"55b31d659b16927771958a15837b10\">penetrating</span> injury enters the eye without exiting, resulting in no exit wound.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sharp objects such as sharpened pencils <strong>(most common cause in children)</strong>, needles, knives, nails, screws, glass, etc.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Damage Mechanisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tearing and structural disruption</li>\n<li>Pathogens enter through open wounds, leading to <strong>ring abscesses</strong>, corneal sloughing, iridocyclitis, endophthalmitis, panophthalmitis, etc. <strong>(Option A)</strong></li>\n</ul>\n<img alt=\"-\" data-author=\"NA\" data-hash=\"1913\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/SZiDOvyeysZ3mXfYjesN1742988864.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Prognosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It depends on the severity of the injury and the complications that arise secondary to the injury.</p>\n<p>Influenced by:</p>\n<ul>\n<li>Initial visual acuity</li>\n<li>Presence of a relative pupillary <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> (RAPD)</li>\n<li>Presence of an <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> foreign body</li>\n<li>Presence of infection</li>\n<li>Presence of a <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> injury or detachment.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gDhePSoxHWhYRa7oA2Nt1748276484.mp3", "video": ""}, {"text": "A 40-year-old construction worker presents with eye pain and blurred vision after metal struck his eye. CT scan reveals an intraocular foreign body lodged in the vitreous cavity. What is the most appropriate treatment?", "options": [{"label": "A", "text": "Observation and follow-up in one week", "correct": false}, {"label": "B", "text": "Corticosteroid injection without IOFB removal", "correct": false}, {"label": "C", "text": "Immediate surgery with pars plana vitrectomy and IOFB removal", "correct": true}, {"label": "D", "text": "Application of topical antibiotics and patching", "correct": false}], "correct_answer": "C. Immediate surgery with pars plana vitrectomy and IOFB removal", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:660px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Intraocular Foreign Bodies (IOFBs)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>An IOFB can lodge in any part of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> or <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> segments, causing mechanical damage, infection, or toxic effects on <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> structures.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Types </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inert: </strong>Glass, wood, plastic, rubber, gold, silver, platinum</p>\n<p><strong>Reactive: </strong>Organic and Inorganic (iron causing siderosis, <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> causing chalcosis).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>History.</li>\n<li>Examination (wound examination, foreign body location, associated signs such as lid <span class=\"customMeta\" data-dictid=\"ff7e91c542169277719182b4b8b68b\">laceration</span> and <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> segment damage should be noted).</li>\n<li><strong>CT (investigation of choice) </strong>with <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> and <span class=\"customMeta\" data-dictid=\"dad5b2152216927771851a3d10cd41\">coronal</span> cuts detects and localizes a <span class=\"customMeta\" data-dictid=\"84433cae211692777192a484f539bc\">metallic</span> IOFB.</li>\n<li>MRI is contraindicated (metallic IOFB).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Magnetic removal (metallic IOFB)</li>\n<li>Forceps removal through <span class=\"customMeta\" data-dictid=\"4bc4237fe3169277719497604c0f00\">pars</span> <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> <span class=\"customMeta\" data-dictid=\"e6aa17c07816927772024116d41015\">vitrectomy</span> <strong>(Option C)</strong></li>\n<li>Prophylaxis against infection (<strong>topical/systemic antibiotics</strong>)<strong> </strong><strong>(Option D ruled out)</strong></li>\n<li>Conservative and supportive management (<strong>topical corticosteroids</strong>, analgesics, etc). <strong>(Option B ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4pHCnQDPpEGfDlNXw2As1747209064.mp3", "video": ""}, {"text": "A 28-year-old metalworker presents with gradual vision loss and a history of a metallic foreign body injury 4 months ago. Examination reveals iron deposits on Iris, rusty deposits on the lens and pigmentary changes in the retina. What is the most likely cause of his condition?", "options": [{"label": "A", "text": "Chalcosis", "correct": false}, {"label": "B", "text": "Retinitis pigmentosa", "correct": false}, {"label": "C", "text": "Siderosis bulbi", "correct": true}, {"label": "D", "text": "Glaucoma", "correct": false}], "correct_answer": "C. Siderosis bulbi", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/rw6jkq4VTFrZNRuVNclC1742988001.png", "https://image.prepladder.com/notes/j3YY3J8jA3Fdatlfryzg1742988002.png", "https://image.prepladder.com/notes/P0HXIJFXu7OFMjRsK08i1742988003.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Siderosis Bulbi</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Degenerative eye condition caused by an <strong>iron-containing foreign body </strong>that is not promptly removed from the eye. <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chisel and <span class=\"customMeta\" data-dictid=\"72db2f68b616927771880970425404\">hammer</span> injury (most common cause)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oxidation and other chemical reactions with surrounding tissues, leading to toxic effects on <span class=\"customMeta\" data-dictid=\"12a6f23332169277718402ca6703e2\">cellular</span> <span class=\"customMeta\" data-dictid=\"0f160e4e42169277718771b715516a\">enzyme</span> systems and subsequent cell death.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical Manifestations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lens deposits (radially distributed iron deposits on the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> lens <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> leading to cataract)</li>\n<li>Heterochromia iridis (iris pigmentation): Reddish-brown <span class=\"customMeta\" data-dictid=\"3b007026bd16927771997ae809b603\">staining</span> of the iris.</li>\n<li>Retinal changes (pigmentary retinopathy), leading to <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">atrophy</span> of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> and RPE (retinal <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> epithelium), potentially leading to profound visual loss.</li>\n<li>Glaucoma (trabecular damage)</li>\n<li><strong>Electroretinography (ERG): </strong>Progressive <span class=\"customMeta\" data-dictid=\"22818451b71692777182237914a233\">attenuation</span> of the b-wave over time.</li>\n</ul>\n<br/>\n<img alt=\"-\" data-author=\"Joanna IM. Silverman, MD; Timothy M. Boyce, MD\" data-hash=\"1883\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/siderosis-bulbi/index.htm#gsc.tab=0\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/rw6jkq4VTFrZNRuVNclC1742988001.png\"/><img alt=\"-\" data-author=\"Joanna IM. Silverman, MD; Timothy M. Boyce, MD\" data-hash=\"1884\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/siderosis-bulbi/index.htm#gsc.tab=0\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/j3YY3J8jA3Fdatlfryzg1742988002.png\"/>\n<p><img alt=\"-\" data-author=\"Joanna IM. Silverman, MD; Timothy M. Boyce, MD\" data-hash=\"1885\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/siderosis-bulbi/index.htm#gsc.tab=0\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/P0HXIJFXu7OFMjRsK08i1742988003.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QhZg4mfe3yScUaN27JGf1747395162.mp3", "video": ""}, {"text": "A 35-year-old male presents to the emergency department after an accidental chemical exposure to his eyes while working in a lab. He reports immediate burning and decreased vision. Upon examination, there is corneal epithelial loss and conjunctival swelling. What is the most appropriate immediate management step?", "options": [{"label": "A", "text": "Necrotic tissue removal and administer topical antibiotics", "correct": false}, {"label": "B", "text": "Apply corticosteroids to reduce inflammation", "correct": false}, {"label": "C", "text": "Immediate irrigation with water or saline for 20-30 minutes", "correct": true}, {"label": "D", "text": "Perform corneal transplant", "correct": false}], "correct_answer": "C. Immediate irrigation with water or saline for 20-30 minutes", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:610px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chemical Injuries</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chemical eye injuries are caused by <span class=\"customMeta\" data-dictid=\"3a983e569716927771805ed22b90d7\">acidic</span> or <span class=\"customMeta\" data-dictid=\"b95c7f7b821692777181df660ee7ff\">alkaline</span> substances entering the eye (accidental or due to assault), presenting a severe <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> emergency that demands immediate treatment.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Alkali burn </strong>(most common, more severe)</p>\n<ul>\n<li>Ammonia (most common), NaOH (sodium hydroxide), <span class=\"customMeta\" data-dictid=\"c59d8f1bae1692777191d7665ba18f\">lime</span> [CaO].</li>\n</ul>\n<p><strong>Acid</strong> (coagulates the surface proteins)</p>\n<ul>\n<li>Hydrofluoric acid (used in glass etching), sulphuric acid</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Others</strong>: Detergents, cosmetics, fertilizers, insecticides, etc.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Immediate management:</strong></p>\n<ul>\n<li>The first and the most crucial step while treating a chemical injury is<strong> copious <span class=\"customMeta\" data-dictid=\"ea6a429a6b1692777190801502ba55\">irrigation</span> (</strong><strong>water or <span class=\"customMeta\" data-dictid=\"894da1dfe6169277719871d7210619\">saline</span> for at least 20-30 minutes or until the eye’s pH is restored</strong><strong>) by double <span class=\"customMeta\" data-dictid=\"30ddb5b09916927771877ac72c09b7\">eversion</span> of the lid. (Option C)</strong></li>\n<li><strong>Debridement: </strong>Carefully <span class=\"customMeta\" data-dictid=\"e0b35b76f816927771875efaec6acd\">excise</span> dead <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> and <span class=\"customMeta\" data-dictid=\"66722262e51692777185764ec20cf4\">corneal epithelium</span> using a cotton swab.<strong>(Option A ruled out)</strong></li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Medical management:</strong></p>\n<ul>\n<li>Antibiotics <strong>(Option A ruled out)</strong></li>\n<li>Cycloplegics (relax the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle),</li>\n<li>Steroids only for an initial 7 days (as they reduce <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> and impair healing). <strong>(Option B ruled out)</strong></li>\n<li>Ascorbic acid (vitamin C) 10% E/D 2hrly. (promotes <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> and improves wound healing)</li>\n<li>Citrate 10% E/D 2 hourly for ten days (controls <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and inhibits collagenase)</li>\n<li>Tetracycline (collagenase inhibitor)</li>\n<li>Acetylcysteine 10% (anti-collagenase)</li>\n</ul>\n\t\t\t \n\n\t\t\t<p><strong>Surgical management</strong></p>\n<ul>\n<li><strong>Early: </strong>Advancement of tenon capsule, <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> cell transplantation, <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> grafting</li>\n<li><strong>Late: </strong>\n<ul>\n<li><strong>Symblepharon:</strong> Division of bands in Symblepharon, conjunctival grafting, <span class=\"customMeta\" data-dictid=\"26080f047a169277719334625cadef\">mucous</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> grafting</li>\n<li><strong>Limbal cells:</strong> <span class=\"customMeta\" data-dictid=\"b03362a9691692777180a2605bdfbf\">Advancement</span> of tenon capsule, <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> cell transplantation, <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> grafting.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Secondary glaucoma</li>\n<li>Limbal stem cell deficiency</li>\n<li>Pseudopterygium</li>\n<li>Corneal <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> (keratoplasty or keratoprosthesis). <strong>(Option D ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/I1G2PpMWalDvrjA6wN5v1747395505.mp3", "video": ""}, {"text": "A 28-year-old male presents to the emergency department 10 days after sustaining blunt trauma to the face during a basketball game. He complains of diplopia and difficulty moving his left eye upwards. On examination, there is significant periorbital swelling. The X-ray is shown below. What does this X-ray indicate in this patient, and what is the most appropriate next step in management?", "options": [{"label": "A", "text": "Orbital fat herniation; apply ice and prescribe analgesics", "correct": false}, {"label": "B", "text": "Orbital floor fracture; surgical evaluation", "correct": true}, {"label": "C", "text": "Orbital haemorrhage; immediate CT scan", "correct": false}, {"label": "D", "text": "Maxillary sinus fracture; follow-up with ENT specialist", "correct": false}], "correct_answer": "B. Orbital floor fracture; surgical evaluation", "question_images": ["https://image.prepladder.com/notes/aO0qhRxqfEjtzzeOVPvL1742988004.png"], "explanation_images": ["https://image.prepladder.com/notes/kNeRJJvIMNLIfC2NIUoI1742990022.png", "https://image.prepladder.com/notes/Do8VedIl8s31OGogUBT41742990018.png", "https://image.prepladder.com/notes/MUqzEISWAeczslBTxmQR1742990018.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 16 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient presents with a foreign body (chuna) in the eye and complaints of irritability and lacrimation. What is the first step in management for this patient?", "options": [{"label": "A", "text": "Antibiotic eye drops B) Ascorbic eye drops C) Irrigation of the eye with normal saline D) Steroids", "correct": false}, {"label": "B", "text": "Ascorbic eye drops", "correct": false}, {"label": "C", "text": "Irrigation of the eye with normal saline", "correct": true}, {"label": "D", "text": "Steroids", "correct": false}], "correct_answer": "C. Irrigation of the eye with normal saline", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A factory worker presented with a history of chuna (lime) exposure in both eyes a few hours ago. What is the first immediate management?", "options": [{"label": "A", "text": "Take history B) Copious irrigation of eyes C) Check vision in both eyes D) Check IOP and plan for surgery", "correct": false}, {"label": "B", "text": "Copious irrigation of eyes", "correct": true}, {"label": "C", "text": "Check vision in both eyes", "correct": false}, {"label": "D", "text": "Check IOP and plan for surgery", "correct": false}], "correct_answer": "B. Copious irrigation of eyes", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:715px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chemical Injuries</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Eye injuries caused by chemicals range from mild <span class=\"customMeta\" data-dictid=\"3a74ed0fcf16927771901a79847565\">irritation</span> to vision loss.</li>\n<li>Sources of Injury\n\t\t\t\t<ul>\n<li>Domestic: Ammonia, detergents, cosmetics</li>\n<li>Agriculture: Fertilizers, insecticides</li>\n<li>Laboratory: Acids, alkalis</li>\n<li>Assaults &amp; Warfare: Acid attacks, chemical weapons</li>\n<li>Self-inflicted: <span class=\"customMeta\" data-dictid=\"5cc0e8df9216927771919ff3e48a1c\">Malingering</span> or mental health conditions</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Alkali vs. Acid Burns</strong>\n<ul>\n<li>Alkali: More severe, deeper <span class=\"customMeta\" data-dictid=\"31dd0b58bb1692777195e6016ecd51\">penetration</span> due to saponification, <span class=\"customMeta\" data-dictid=\"4d432538a61692777189318b8f528c\">hygroscopic</span> nature, and <span class=\"customMeta\" data-dictid=\"845fedd06d16927771989597afa034\">soluble</span> compounds formation.</li>\n<li>Acid: Less severe, protein <span class=\"customMeta\" data-dictid=\"42f1e4deb8169277718412c0681a54\">coagulation</span> forms a protective barrier.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Stages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Acute: Conjunctival swelling, corneal epithelial loss, <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> inflammation, possible corneal <span class=\"customMeta\" data-dictid=\"1e7a15285e1692777198023b252c8c\">sloughing</span> and staphyloma.</li>\n<li>Reparation: Epithelial regeneration, corneal vascularization, <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> subsides.</li>\n<li>Complications: Symblepharon, <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> ulcers, cataracts, secondary glaucoma.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Emergency Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Immediate irrigation</strong>: Use water or <span class=\"customMeta\" data-dictid=\"894da1dfe6169277719871d7210619\">saline</span> for at least 20-30 minutes or until the eye’s pH is restored. A minimum of 2 liters should be used. <strong>(Option B)</strong></li>\n<li><strong>Mechanical removal</strong>: Gently remove any chemical particles with a cotton swab, particularly in <span class=\"customMeta\" data-dictid=\"c59d8f1bae1692777191d7665ba18f\">lime</span> burns.</li>\n<li><strong>Necrotic tissue removal</strong>: Carefully <span class=\"customMeta\" data-dictid=\"e0b35b76f816927771875efaec6acd\">excise</span> dead <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> and <span class=\"customMeta\" data-dictid=\"66722262e51692777185764ec20cf4\">corneal epithelium</span> using a cotton swab.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Healing &amp; <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">Complication</span> Prevention</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Topical antibiotics: Use <span class=\"customMeta\" data-dictid=\"583de7632e16927771834054d1be58\">broad-spectrum</span> antibiotics like <span class=\"customMeta\" data-dictid=\"ea2e8c291e169277719273188accfd\">moxifloxacin</span> to prevent infection.</li>\n<li>Topical steroids: Control <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> and <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis. Use cautiously after two weeks to avoid hindering <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> production.</li>\n<li>Cycloplegics: Alleviate pain and <span class=\"customMeta\" data-dictid=\"7e9bc153d616927771866a8608d1a5\">dilate</span> the <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> with agents like atropine.</li>\n<li>Ascorbic acid: Promote wound <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> and <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> <span class=\"customMeta\" data-dictid=\"3fda45538a1692777199ec2a5478a5\">synthesis</span> using <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> and <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> Vitamin C.</li>\n<li>Lubricants: Use preservative-free artificial <span class=\"customMeta\" data-dictid=\"1717bdb5d21692777200d45e31ceed\">tears</span> to keep the eye moist and support healing.</li>\n<li>Autologous serum: Use <span class=\"customMeta\" data-dictid=\"1ffaec13de169277719828374cfda0\">serum</span> <span class=\"customMeta\" data-dictid=\"fe2c08a01b1692777187011e915049\">eye drops</span> to provide essential growth factors for healing.</li>\n<li>Sodium citrate: Stabilise neutrophils and reduce <span class=\"customMeta\" data-dictid=\"c551557c43169277718498a921e9e2\">collagenase</span> activity with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> sodium citrate.</li>\n<li>Doxycycline: <span class=\"customMeta\" data-dictid=\"6b3de87b7c16927771901326efbcd2\">Inhibit</span> <span class=\"customMeta\" data-dictid=\"c551557c43169277718498a921e9e2\">collagenase</span> activity with oral doxycycline.</li>\n<li>Symblepharon Prevention:Use a glass shell or sweep a glass rod in the fornices (spaces between the <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> and eyeball) twice daily to prevent adhesions.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complication Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Secondary glaucoma: Control <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure with beta-blockers like <span class=\"customMeta\" data-dictid=\"44f66117c1169277720085f515550a\">timolol</span> or carbonic <span class=\"customMeta\" data-dictid=\"0a72e82d651692777181ef79d77e61\">anhydrase</span> inhibitors such as acetazolamide.</li>\n<li>Limbal stem cell deficiency: Consider <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> or <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> stem cell transplantation.</li>\n<li>Pseudopterygium: Surgically remove <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> conjunctival growth and consider <span class=\"customMeta\" data-dictid=\"9624c770251692777182ec72ea776c\">autografting</span> or <span class=\"customMeta\" data-dictid=\"2c0fb943ce16927771815ddeb9824d\">amniotic</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> transplantation.</li>\n<li>Corneal opacity: Consider <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> or keratoprosthesis for severe corneal damage.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Implications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chemical injuries can cause permanent vision loss, physical disfigurement and psychological impact despite treatment.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient has a history of a flying foreign body injury to the eye. Hemochromatosis is subsequently diagnosed. Which of the following substances is most likely involved in the deposition?", "options": [{"label": "A", "text": "Iron", "correct": true}, {"label": "B", "text": "Aluminum", "correct": false}, {"label": "C", "text": "Wood", "correct": false}, {"label": "D", "text": "Glass", "correct": false}], "correct_answer": "A. Iron", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:660px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intraocular Foreign Bodies (IOFBs)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>An IOFB can lodge in any part of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> or <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> segments, causing mechanical damage, infection, or toxic effects on <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> structures.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inert: </strong>Glass, wood, plastic, rubber, gold, silver, platinum</p>\n<p><strong>Reactive: </strong>Organic and <span class=\"customMeta\" data-dictid=\"fae9d02cdc1692777190a3151d6fef\">Inorganic</span> (iron causing siderosis, <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> causing chalcosis).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>History.</li>\n<li>Examination (wound examination, foreign body location, associated signs such as lid <span class=\"customMeta\" data-dictid=\"ff7e91c542169277719182b4b8b68b\">laceration</span> and <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> segment damage should be noted).</li>\n<li><strong>CT (investigation of choice) </strong>with <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> and <span class=\"customMeta\" data-dictid=\"dad5b2152216927771851a3d10cd41\">coronal</span> cuts detects and localizes a <span class=\"customMeta\" data-dictid=\"84433cae211692777192a484f539bc\">metallic</span> IOFB.</li>\n<li>MRI is contraindicated (metallic IOFB).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Magnetic removal (metallic IOFB)</li>\n<li>Forceps removal through <span class=\"customMeta\" data-dictid=\"4bc4237fe3169277719497604c0f00\">pars</span> <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> vitrectomy</li>\n<li>Prophylaxis against infection (topical/systemic antibiotics)<strong> </strong></li>\n<li>Conservative and supportive management (topical corticosteroids, analgesics, etc).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The patient presents with foreign body (chuna) in his eyes and complaints of irritability and lacrimation. What is the first step management in this patient?", "options": [{"label": "A", "text": "Antibiotics eye drops", "correct": false}, {"label": "B", "text": "Ascorbic eye drops", "correct": false}, {"label": "C", "text": "Irrigation of eye with normal saline", "correct": true}, {"label": "D", "text": "Steroids", "correct": false}], "correct_answer": "C. Irrigation of eye with normal saline", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"ea6a429a6b1692777190801502ba55\"&gt;Irrigation&lt;/span&gt; of the eye with\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which investigation is most suitable for localizing a foreign body in the eye of an industrial worker admitted to the hospital due to an eye injury caused by cutting stone with a hammer and iron chisel?", "options": [{"label": "A", "text": "B mode scan", "correct": false}, {"label": "B", "text": "CT", "correct": true}, {"label": "C", "text": "X-ray", "correct": false}, {"label": "D", "text": "MRI", "correct": false}], "correct_answer": "B. CT", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>An IOFB is a foreign object that penetrates the eye and remains lodged inside. It is a serious injury that can result in permanent vision loss.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Common Types of IOFBs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Metallic (90% of cases): Iron, steel.</li>\n<li>Others: Glass, stone, lead pellets, copper, aluminium, plastic, wood.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Foreign Body Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Inorganic Materials: </strong>Glass, plastic are inert; lead, aluminium, <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> cause <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> responses.</li>\n<li><strong>Organic Materials: </strong>Wood causes <strong>giant cell reactions</strong> and <strong>granulomatous inflammation</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Detailed History: Understand injury mechanism for IOFB type.</li>\n<li><strong>Ocular Examination:</strong>\n<ul>\n<li>Slit-lamp examination</li>\n<li>Gonioscopy</li>\n<li>Ophthalmoscopy (back of the eye)</li>\n</ul>\n</li>\n<li><strong>Signs:</strong>\n<ul>\n<li>Subconjunctival hemorrhage</li>\n<li>Corneal scars/ <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">Iris</span> holes</li>\n<li>Opaque tracks in the lens/ IOFB in <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> or retina</li>\n</ul>\n</li>\n<li><strong>Investigations:</strong>\n<ul>\n<li>X-rays: Less common; CT is preferred. <strong>(Option C)</strong></li>\n<li>Ultrasonography: B-mode USG locates both <span class=\"customMeta\" data-dictid=\"76584c702f1692777197ee90a74461\">radiopaque</span> and non-radiopaque IOFBs. <strong>(Option A)</strong></li>\n<li><strong>CT Scan: Investigation of choice/ Gold standard</strong> for detailed cross-sectional images.<strong>(Option B)</strong></li>\n<li><strong>MRI: Contra-indicated in case of metal foreign bodies (Option D)</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>IOFB Removal:</strong> Essential except for inert, <span class=\"customMeta\" data-dictid=\"fc3d080799169277719904701c07f9\">sterile</span> IOFBs not affecting vision or if removal is too risky.\n\t\t\t\t<ul>\n<li>Magnetic IOFBs: Removed using a handheld electromagnet.</li>\n<li>Non-magnetic IOFBs: Requires specialized procedures.</li>\n</ul>\n</li>\n<li><strong>Removal Methods:</strong>\n<ul>\n<li><strong>Anterior Chamber:</strong>\n<ul>\n<li>Corneal incision, avoiding central cornea.</li>\n<li>Magnetic IOFBs: Handheld magnet.</li>\n<li>Non-magnetic IOFBs: Specialized forceps.</li>\n</ul>\n</li>\n<li><strong>Iris: </strong>Sector <span class=\"customMeta\" data-dictid=\"744b697ac31692777190fa2c638b3a\">iridectomy</span> for IOFBs in the iris.</li>\n<li><strong>Lens:</strong> <span class=\"customMeta\" data-dictid=\"ab0f3917ce1692777187309ec78709\">Extracapsular</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">extraction</span> <strong>(ECCE)</strong> with or without lens removal.</li>\n<li><strong>Vitreous and Retina: <span class=\"customMeta\" data-dictid=\"4bc4237fe3169277719497604c0f00\">Pars</span> <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> vitrectomy</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Post-Removal Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Topical/systemic antibiotics for infection prevention.</li>\n<li>Topical corticosteroids to reduce inflammation.</li>\n<li>Cycloplegic agents (e.g., atropine) for <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> and pain relief.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was brought to the outpatient department with a history of trauma near the eye and now presents with symptoms of fever, severe pain, and swelling in the left eye. On examination, no abnormal findings were observed. What is the likely diagnosis?", "options": [{"label": "A", "text": "Orbital cellulitis", "correct": false}, {"label": "B", "text": "Endophthalmitis", "correct": false}, {"label": "C", "text": "Panophthalmitis", "correct": false}, {"label": "D", "text": "Preseptal cellulitis", "correct": true}], "correct_answer": "D. Preseptal cellulitis", "question_images": ["https://image.prepladder.com/content/ToLJvIVabct4YBQ0ip6n1746102143.png"], "explanation_images": ["https://image.prepladder.com/content/sfV271I8MqXnBx3dwS131746102217.png", "https://image.prepladder.com/content/k2PGdjWrQ1TouvHBvJNv1746102217.png", "https://image.prepladder.com/content/W1VCGRAuE5CnTPb9HY5h1746102217.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Orbital <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> is an <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> infection of the soft tissues of the orbit located behind the <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Sinusitis: Ethmoid <span class=\"customMeta\" data-dictid=\"3207c2541a1692777198f4af88308b\">sinusitis</span> (most common) carries a high risk of causing <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis. (Option A)</li>\n<li>Underlying <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> problem.</li>\n<li>Dacryocystitis (inflammation of the <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> sac).</li>\n<li>Endogenous cause: Septicemia</li>\n<li>Exogenous cause: Fracture or surgery of the orbit.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Causative Organisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Staphylococcus aureus (most common)</li>\n<li>Haemophilus influenzae (most common in children)</li>\n<li>Streptococcus pneumoniae</li>\n<li>Streptococcus pyogenes</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Preseptal cellulitis:</strong> Fever, pain, swelling, <span class=\"customMeta\" data-dictid=\"169e1c9eb416927772006ea5a02252\">tenderness</span> on the outer <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> region. <strong>(Option D)</strong></li>\n<li><strong>Orbital cellulitis: (Option A)</strong>\n<ul>\n<li>Painful, <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> <span class=\"customMeta\" data-dictid=\"4edef7912e1692777196cb0f66e35d\">Proptosis</span> (swelling and severe pain worsened by eye movement or pressure)</li>\n<li>Restriction of eye movements (due to proptosis)</li>\n<li>Decreased visual acuity</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Staging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Modified Chandler <span class=\"customMeta\" data-dictid=\"8ea2e3870f16927771990a138acbc1\">staging</span> system:</strong></p>\n<ul>\n<li><strong>Stage I: Preseptal cellulitis/ <span class=\"customMeta\" data-dictid=\"5b1b31d3e41692777195670afc94ca\">periorbital</span> cellulitis</strong> (limited <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> to the <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum) <strong>(Option D)</strong></li>\n<li><strong>Stage II:</strong> Inflammatory <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> oedema/ <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">Orbital</span> <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> (Posterior to <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum)</li>\n<li><strong>Stage III:</strong> Subperiosteal abscess</li>\n<li><strong>Stage IV: </strong>Orbital abscess</li>\n<li><strong>Stage V: </strong>Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</li>\n</ul>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"608\" src=\"https://image.prepladder.com/content/W1VCGRAuE5CnTPb9HY5h1746102217.png\" width=\"608\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Antibiotics (IV): Empirical therapy treats <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> by giving Ceftazidime, Vancomycin, and Metronidazole.</li>\n<li>Monitoring of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve function</li>\n<li>Surgery: Drainage of an <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> or infected sinuses should be considered if there is a lack of response to antibiotics.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A man suffered trauma to the eye from a punch while fighting with another person. What is the most common site of fracture in orbit?", "options": [{"label": "A", "text": "Medial wall", "correct": false}, {"label": "B", "text": "Lateral wall", "correct": false}, {"label": "C", "text": "Roof", "correct": false}, {"label": "D", "text": "Floor", "correct": true}], "correct_answer": "D. Floor", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KfEeenANj7pzWGGYg0Lt1746102794.png", "https://image.prepladder.com/content/tcmz0bU5JWmR8V7A6zJh1746102794.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:613px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Blow-out <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> fractures result from trauma causing backward <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of the <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> and an increase in <span class=\"customMeta\" data-dictid=\"537708a987169277719097ee31f0eb\">intraorbital</span> pressure, leading to a resultant fracture.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Pure blow-out fractures: Not associated with involvement of the <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> rim.</li>\n<li>Impure blow-out fractures: Associated with other fractures in the middle third of the <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> skeleton.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Periorbital oedema</strong> and blood <span class=\"customMeta\" data-dictid=\"f0c6fefae41692777187c76a6f65f6\">extravasation</span> (e.g., <strong>subconjunctival ecchymosis</strong>)</li>\n<li>Emphysema of the eyelids, more common with <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> wall fractures</li>\n<li><strong>Paraesthesia</strong> and anaesthesia in the distribution of the <strong>infraorbital nerve</strong> (lower lid, cheek, side of nose, upper lip, and upper teeth)</li>\n<li>Ipsilateral <span class=\"customMeta\" data-dictid=\"26bb4e3cc81692777187ce44e530e5\">epistaxis</span> (bleeding from maxillary sinus)</li>\n<li>Proptosis, often due to <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> oedema and haemorrhage</li>\n<li><strong>Enophthalmos</strong> (due to <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> fat escape, muscle entrapment, and <span class=\"customMeta\" data-dictid=\"ddba4206eb169277718335596e86da\">cavity</span> enlargement)</li>\n<li><strong>Diplopia</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Radiography</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>X-ray:</strong> <strong>Water’s view</strong> shows <strong>‘hanging drop’ opacity</strong> of the superior maxillary <span class=\"customMeta\" data-dictid=\"96976bc5fc1692777181dc8403015a\">antrum</span> due to <span class=\"customMeta\" data-dictid=\"18b73c28601692777188f2aae28838\">herniated</span> <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> contents.</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Cobb, A. R., Murthy, R., Saiet, J., Bailey, B., &amp; Hibbert, J.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://www.sciencedirect.com/science/article/abs/pii/S0266435608000417\" data-tags=\"\" height=\"700\" src=\"https://image.prepladder.com/content/KfEeenANj7pzWGGYg0Lt1746102794.png\" width=\"570\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<ul>\n<li><strong>CT/MRI: </strong>Coronal sections show extent of the <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> and herniation- <strong>hanging drop or tear drop sign</strong></li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Gooris, Peter &amp; Mourits, Maarten &amp; Mensink, Gertjan &amp; Bergsma, Jan.\" data-hash=\"\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Teardrop-sign-as-a-result-of-an-orbital-floor-trapdoor-fracture-OS-coronal-view_fig4_376932263\" data-tags=\"\" height=\"209\" src=\"https://image.prepladder.com/content/tcmz0bU5JWmR8V7A6zJh1746102794.png\" width=\"248\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>General Measures and Medical Treatment:</strong></p>\n<ul>\n<li>Avoid nose blowing</li>\n<li>Systemic antibiotics to prevent <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> infection</li>\n<li>Analgesics and anti-inflammatory drugs</li>\n<li>Cold compresses to decrease swelling</li>\n</ul>\n<p><strong>Surgical Management:</strong></p>\n<ul>\n<li>Optimal surgery time: <strong>10-14 days after injury</strong></li>\n<li>Surgical indications: Persistent diplopia, large herniation, tissue incarceration, <span class=\"customMeta\" data-dictid=\"1f51f462bc1692777187ffc9d3094b\">enophthalmos</span> &gt;3mm</li>\n</ul>\n<p><strong>Orbital Surgeries:</strong></p>\n<ul>\n<li>Orbitotomy: 4 approaches: anterior, lateral, transfrontal, and temporofrontal</li>\n<li>Exenteration: Removal of all <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> contents and <span class=\"customMeta\" data-dictid=\"cd7fce2afd1692777195bc79cdc10b\">periorbita</span> through an <span class=\"customMeta\" data-dictid=\"2afbd932801692777190be690704b3\">incision</span> along <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> margins.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Can you determine the observation indicated by the arrow in the image provided?", "options": [{"label": "A", "text": "Vossius ring", "correct": true}, {"label": "B", "text": "Weiss ring", "correct": false}, {"label": "C", "text": "Fleischer’s ring", "correct": false}, {"label": "D", "text": "Kayser Fleischer ring", "correct": false}], "correct_answer": "A. Vossius ring", "question_images": ["https://image.prepladder.com/content/akGOZQXWmBl2kHXArw2R1745576669.png"], "explanation_images": ["https://image.prepladder.com/content/m6dmNlgB5fjrgOxgNmiG1745576714.png", "https://image.prepladder.com/notes/jpxti7CquUIKttJMNVB71747058528.png", "https://image.prepladder.com/content/oDOWNYmcv0SSJqhWRPge1745576714.png", "https://image.prepladder.com/content/Yq2kq0Ffz8ztP5FvuJsn1745576714.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:633px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Damage Mechanisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Direct Impact: Greatest damage at impact site.</li>\n<li>Compression Wave Force: Distant damage (\"contrecoup\").</li>\n<li>Indirect Force: Damage from impact against <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> walls.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Specific Injuries</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Cornea:<strong> Descemet's <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> tears</strong></li>\n<li>Conjunctiva: Subconjunctival haemorrhage</li>\n<li>Anterior Chamber: <strong>Hyphema (most common sign)</strong>, exudates.</li>\n<li>Iris, Pupil, Ciliary Body: Iridodialysis,Iridodonesis.</li>\n<li>Lens: <strong>Rosette shaped cataract</strong>, <span class=\"customMeta\" data-dictid=\"90d1792ffd1692777186055806b5ce\">ectopia</span> lentis, <strong>Vossius ring</strong></li>\n<li>Vitreous: Liquefaction, opacities, detachment.</li>\n<li>Choroid: <strong>choroidal rupture(bucket handle type)</strong></li>\n<li>Retina: <strong>Commotio retinae</strong>, <strong>Rhegmatogenous <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment</strong>, <strong>Gray white <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> due to Berlin's edema.</strong></li>\n<li>Intraocular Pressure: <strong>Traumatic glaucoma</strong>, hypotony, <strong>ghost cell glaucoma</strong>, <span class=\"customMeta\" data-dictid=\"a6d54c652f16927771820dfa93b368\">angle recession</span> glaucoma</li>\n<li><strong>Traumatic <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> neuropathy-RAPD </strong>(relative <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> pupillary defect)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "An industrial worker was admitted to the hospital after an eye injury sustained while cutting stone with a hammer and iron chisel. A foreign body was suspected to be impacted in his eye. Which investigation can be detrimental to this patient?", "options": [{"label": "A", "text": "B mode scan", "correct": false}, {"label": "B", "text": "CT", "correct": false}, {"label": "C", "text": "X-ray", "correct": false}, {"label": "D", "text": "MRI", "correct": true}], "correct_answer": "D. MRI", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer D - MRI</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>An IOFB is a foreign object that penetrates the eye and remains lodged inside. It is a serious injury that can result in permanent vision loss.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Common Types of IOFBs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Metallic (90% of cases): Iron, steel.</li>\n<li>Others: Glass, stone, lead pellets, copper, aluminium, plastic, wood.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Foreign Body Reactions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Inorganic Materials: </strong>Glass, plastic are inert; lead, aluminium, <span class=\"customMeta\" data-dictid=\"7b5fb2b56416927771858f02fd5508\">copper</span> cause <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> responses.</li>\n<li><strong>Organic Materials: </strong>Wood causes <strong>giant cell reactions</strong> and <strong>granulomatous inflammation</strong>.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Detailed History: Understand injury mechanism for IOFB type.</li>\n<li><strong>Ocular Examination:</strong>\n<ul>\n<li>Slit-lamp examination</li>\n<li>Gonioscopy</li>\n<li>Ophthalmoscopy (back of the eye)</li>\n</ul>\n</li>\n<li><strong>Signs:</strong>\n<ul>\n<li>Subconjunctival hemorrhage</li>\n<li>Corneal scars/ <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">Iris</span> holes</li>\n<li>Opaque tracks in the lens/ IOFB in <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> or retina</li>\n</ul>\n</li>\n<li><strong>Investigations:</strong>\n<ul>\n<li>X-rays: Less common; CT is preferred.</li>\n<li>Ultrasonography: B-mode USG locates both <span class=\"customMeta\" data-dictid=\"76584c702f1692777197ee90a74461\">radiopaque</span> and non-radiopaque IOFBs.</li>\n<li><strong>CT Scan:</strong> <strong> Investigation of choice/ Gold standard</strong> for detailed cross-sectional images.</li>\n<li><strong>MRI: Contra-indicated in case of metal foreign bodies (Option D)</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>IOFB Removal: Essential except for inert, <span class=\"customMeta\" data-dictid=\"fc3d080799169277719904701c07f9\">sterile</span> IOFBs not affecting vision or if removal is too risky.\n\t\t\t\t<ul>\n<li>Magnetic IOFBs: Removed using a handheld electromagnet.</li>\n<li>Non-magnetic IOFBs: Requires specialized procedures.</li>\n</ul>\n</li>\n<li><strong>Removal Methods:</strong>\n<ul>\n<li><strong>Anterior Chamber:</strong>\n<ul>\n<li>Corneal incision, avoiding central cornea.</li>\n<li>Magnetic IOFBs: Handheld magnet.</li>\n<li>Non-magnetic IOFBs: Specialized forceps.</li>\n</ul>\n</li>\n<li><strong>Iris: </strong>Sector <span class=\"customMeta\" data-dictid=\"744b697ac31692777190fa2c638b3a\">iridectomy</span> for IOFBs in the iris.</li>\n<li><strong>Lens:</strong> <span class=\"customMeta\" data-dictid=\"ab0f3917ce1692777187309ec78709\">Extracapsular</span> <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">extraction</span> <strong>(ECCE)</strong> with or without lens removal.</li>\n<li><strong>Vitreous and Retina: <span class=\"customMeta\" data-dictid=\"4bc4237fe3169277719497604c0f00\">Pars</span> <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> vitrectomy</strong></li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Post-Removal Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Topical/systemic antibiotics for infection prevention.</li>\n<li>Topical corticosteroids to reduce inflammation.</li>\n<li>Cycloplegic agents (e.g., atropine) for <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> and pain relief.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable cause of bleeding in a patient who experienced a hyphema after being struck in the eye by a tennis ball?", "options": [{"label": "A", "text": "Circulus arteriosus major", "correct": false}, {"label": "B", "text": "Anterior ciliary artery", "correct": true}, {"label": "C", "text": "Posterior ciliary artery", "correct": false}, {"label": "D", "text": "Circulus arteriosus minor", "correct": false}], "correct_answer": "B. Anterior ciliary artery", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\"&gt;Anterior&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\"&gt;ciliary&lt;/span&gt; artery</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Structure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Arterial Supply</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cornea</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Avascular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctiva</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anterior <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries, branches of <span class=\"customMeta\" data-dictid=\"c09776e61f1692777194db295c590f\">ophthalmic</span> artery</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Sclera</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Posterior <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries (short and long branches) (Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Iris</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Major <span class=\"customMeta\" data-dictid=\"7e753993b1169277718285a7ef80d6\">arterial circle</span> of the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> (circulus arteriosus major) (Option A) </strong>formed by <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> and long <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ciliary Body</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anterior <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries</strong> and long <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Choroid</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Short <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Retina </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> artery</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lens</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Avascular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Extraocular Muscles</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Muscular branches of the <span class=\"customMeta\" data-dictid=\"c09776e61f1692777194db295c590f\">ophthalmic</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (including <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Eyelids</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Ophthalmic <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (superior and <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> palpebral branches), <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> artery</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lacrimal Gland</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lacrimal artery</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents to the emergency and his ocular examination reveals the following. Which of the following is not done initially?", "options": [{"label": "A", "text": "Removal of the foreign body", "correct": true}, {"label": "B", "text": "Check for visual acuity", "correct": false}, {"label": "C", "text": "Slit lamp examination", "correct": false}, {"label": "D", "text": "Do primary survey", "correct": false}], "correct_answer": "A. Removal of the foreign body", "question_images": ["https://image.prepladder.com/content/oRqejTZ9F7hWSdguXjrL1715662553.png"], "explanation_images": [], "explanation": "<p>Correct Option A - Removal of the foreig\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 21 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following are features of direct ophthalmoscopy? Erect, virtual image is formed 2.5x magnification Large field of view Peripheral retinal lesions can be examined Routine fundus examination Semi-dark room required", "options": [{"label": "A", "text": "1,5,6", "correct": true}, {"label": "B", "text": "1,2,3,4,5,6", "correct": false}, {"label": "C", "text": "1,3,6", "correct": false}, {"label": "D", "text": "3,4", "correct": false}], "correct_answer": "A. 1,5,6", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/fo1cusPEfJfy9zgR2mZj1743682341.png", "https://image.prepladder.com/notes/uYXAkbgdL4tUvlv3boQE1743682294.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristic</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct Ophthalmoscopy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indirect Ophthalmoscopy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image of <span class=\"customMeta\" data-dictid=\"415c59955f16927771947b9c105bbf\">ophthalmoscope</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP009\" data-author=\"\" data-hash=\"7045\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fo1cusPEfJfy9zgR2mZj1743682341.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP008\" data-author=\"\" data-hash=\"7044\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uYXAkbgdL4tUvlv3boQE1743682294.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Erect, virtual</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Real, inverted</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Magnification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>About 15x (more in myopes, less in hypermetropes)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>About 2.5x with a +20D lens, smaller with stronger lenses</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Field of View</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limited, detailed central <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> examination</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Larger field of view</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Uses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Routine <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">fundus</span> examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Essential for assessing <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> and <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> lesions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prerequisites</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Semi-darkroom</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Darkroom, dilated pupils, <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> lens (+20D), <span class=\"customMeta\" data-dictid=\"eadd1d717a16927771833964224058\">binocular</span> ophthalmoscope</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FJJ0jpdkIPiroWI2cGjj1747212871.mp3", "video": ""}, {"text": "All of the following are true regarding the procedure shown below except", "options": [{"label": "A", "text": "It's an objective method for refraction testing", "correct": false}, {"label": "B", "text": "Red reflex moving with the movement of this instrument implies Hypermetropia", "correct": false}, {"label": "C", "text": "Results are unreliable if the patient’s accommodation is active", "correct": false}, {"label": "D", "text": "Cycloplegics are only indicated for children below 5 years of age", "correct": true}], "correct_answer": "D. Cycloplegics are only indicated for children below 5 years of age", "question_images": ["https://image.prepladder.com/notes/l9ayDxz1YuCNY21Ipd2t1743682848.png"], "explanation_images": ["https://image.prepladder.com/notes/K5qs9Lr9v4E0d8FLbXiq1743682932.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Also known as <strong>skiascopy</strong> or shadow test</li>\n<li><strong>Objective method</strong> to assess <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors <strong>(Option A) </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Principle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The direction of the <span class=\"customMeta\" data-dictid=\"014b1a7b931692777197f57251720d\">reflected</span> light traveling over the <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> depends upon the <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> state of the eye</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Types of Retinoscopes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mirror retinoscope: </strong></p>\n<ul>\n<li>Plane (used commonly)</li>\n<li>Concave (in hazy media and high ametropia)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Self-illuminated retinoscope: </strong></p>\n<ul>\n<li>Spot</li>\n<li>Streak <span class=\"customMeta\" data-dictid=\"34c5ba90691692777197c69ce07699\">retinoscope</span> (more sensitive)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Wet retinoscopy:</strong> used with cycloplegics</li>\n<li><strong>Dry retinoscopy:</strong> without cycloplegics</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Static retinoscopy:</strong> No active accommodation</li>\n<li><strong>Dynamic retinoscopy: </strong>Performed with active accommodation</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The patient sits 1 meter from the examiner and light is <span class=\"customMeta\" data-dictid=\"014b1a7b931692777197f57251720d\">reflected</span> onto the eye.</li>\n<li>The examiner observes the red <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> and notes its movement in <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> and vertical meridians.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cycloplegics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cycloplegics can be used in any age group if active <span class=\"customMeta\" data-dictid=\"c0682eacfc1692777180ad2c556c19\">accommodation</span> is present. <strong>(Option D) </strong></li>\n</ul>\n<p><strong>Commonly used cycloplegics:</strong></p>\n<ul>\n<li><strong>Atropine: used in &lt; 5 years age</strong>, Homatropine: 5-25 years</li>\n<li>Phenylephrine (Mydriatic) in elderly</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Observations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>With movement: <span class=\"customMeta\" data-dictid=\"355419a4a3169277718789ac048e32\">Emmetropia</span> or <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> <strong>(Option B) </strong></li>\n<li>Against movement: <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">Myopia</span> &gt;1D</li>\n<li>No movement: <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">Myopia</span> 1D</li>\n</ul>\n<img alt=\"OP489\" data-author=\"\" data-hash=\"7054\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/K5qs9Lr9v4E0d8FLbXiq1743682932.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Difficulties in Retinoscopy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Poor red <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> (small pupil, hazy media, high ametropia)</li>\n<li>Active <span class=\"customMeta\" data-dictid=\"c0682eacfc1692777180ad2c556c19\">accommodation</span> (eliminated by cycloplegia) <strong>(Option C) </strong></li>\n<li>Scissor or conflicting shadows</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LCYcCySUCvLBRnTU4jUu1747235258.mp3", "video": ""}, {"text": "A 50-year-old male presented to the ophthalmology clinic with complaints of difficulty in reading newspapers and books. Which among the following statements is inappropriate regarding the management of this patient?", "options": [{"label": "A", "text": "Roughly +1D convex lenses can be prescribed", "correct": true}, {"label": "B", "text": "Coexisting refractive error (myopia/hypermetropia) should be corrected first", "correct": false}, {"label": "C", "text": "1.25% Pilocarpine can be beneficial in treatment", "correct": false}, {"label": "D", "text": "Conductive keratoplasty can be performed", "correct": false}], "correct_answer": "A. Roughly +1D convex lenses can be prescribed", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Physiological <span class=\"customMeta\" data-dictid=\"80feaae4b31692777190ea1ba3fc25\">insufficiency</span> of <span class=\"customMeta\" data-dictid=\"c0682eacfc1692777180ad2c556c19\">accommodation</span> is typically associated with aging.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etio - Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Age-related factors:</strong></p>\n<ul>\n<li>Decreased <span class=\"customMeta\" data-dictid=\"d6c754309d16927771874142ec8ca4\">elasticity</span> of the lens capsule.</li>\n<li>Sclerosis of the lens.</li>\n<li>Possible decline in <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle power.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Premature causes:</strong></p>\n<ul>\n<li>Uncorrected hypermetropia</li>\n<li>Chronic glaucoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Difficulty in near vision</li>\n<li>Asthenopic symptoms (eye fatigue)</li>\n<li>Intermittent diplopia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Options</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optical Treatment:</strong></p>\n<ul>\n<li>Convex <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> based on age</li>\n<li>Correct <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> error for distance first <strong>(Option B) </strong></li>\n<li>Types of Glasses: Unifocal, bifocal, or progressive (varifocal).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacological therapy:1.25% Pilocarpine</strong>(FDA-approved) <strong>(Option C) </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Surgical options:</strong></p>\n<ul>\n<li>Conductive <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">keratoplasty</span> <strong>(Option D) </strong></li>\n<li>LASIK (Monovision/presbyopic multifocal-LASIK)</li>\n<li>Corneal inlays</li>\n<li>Multifocal <span class=\"customMeta\" data-dictid=\"ffac6924ab16927771907dbb6fd7dd\">IOL</span> placement following lens extraction</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:185px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>40 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+1.00D</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>45 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+1.50D</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>50 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+2.00D <strong>(Option D)</strong><strong> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>55 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+2.25D</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>60 years</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+2.50D</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fFuvFDmGwV2ZNX1laLYx1747234931.mp3", "video": ""}, {"text": "All of the following are changes not related to accommodation except", "options": [{"label": "A", "text": "Anterior lens curvature almost remains the same", "correct": false}, {"label": "B", "text": "Posterior lens curvature is increased", "correct": false}, {"label": "C", "text": "Increased zonular tension", "correct": false}, {"label": "D", "text": "Ciliary muscle contraction", "correct": true}], "correct_answer": "D. Ciliary muscle contraction", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The mechanism by which the eye increases the power of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens to focus on near objects, allowing diverging rays to be focused on the retina.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Changes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>The <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> surface of the lens increases</strong> <strong>(Option A) </strong></li>\n<li>Posterior surface <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> almost remains the same <strong>(Option B)</strong></li>\n<li><strong>Contraction of the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle</strong> <strong>( Option D)</strong></li>\n<li><strong>Relaxation of zonules</strong><strong> (Option C) </strong>secondary to <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle <span class=\"customMeta\" data-dictid=\"ca2289e348169277718516017eb2ba\">contraction</span> (Helmholtz’s capsular theory)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Far Point (Punctum Remotum)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Emmetropic eye - the far point is at infinity</li>\n<li><strong>Hypermetropic eye - behind the eye</strong></li>\n<li><strong>Myopic eye - in front of the eye</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Near Point (Punctum Proximum)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Increases with age</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Range of Accommodation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The distance between the far point and the near point.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amplitude of Accommodation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The difference in <span class=\"customMeta\" data-dictid=\"e474c940ee1692777186066a0842a4\">dioptric</span> power needed to focus between the near point (P) and the far point (R).</li>\n<li>Expressed as A = P - R</li>\n<li>The <span class=\"customMeta\" data-dictid=\"4c75de951316927771819cdfdbdd6a\">amplitude</span> of <span class=\"customMeta\" data-dictid=\"c0682eacfc1692777180ad2c556c19\">accommodation</span> decreases with age.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HhaufilKfILk1OkrJBhm1747234307.mp3", "video": ""}, {"text": "A patient post cataract lens extraction refused IOL placement and hence was prescribed spectacles. Later, he presented with complaints of visual discomfort. Choose the right combination of effects the patient would have likely felt. 1) Pincushion effect of distortion 2) Barrel effect of distortion 3) There is magnification of the image 4) There is a minification of the image", "options": [{"label": "A", "text": "1,3", "correct": true}, {"label": "B", "text": "1,4", "correct": false}, {"label": "C", "text": "2,3", "correct": false}, {"label": "D", "text": "2,4", "correct": false}], "correct_answer": "A. 1,3", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/FRdwxXOXAJzsIjUfzdsK1743682690.png", "https://image.prepladder.com/notes/9ghHIghpg8hdlGvjaRF51743682733.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pincushion <span class=\"customMeta\" data-dictid=\"eaec97de1d1692777186b2ce902b4d\">distortion</span> </strong><strong>(Statement-1)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Barrel <span class=\"customMeta\" data-dictid=\"eaec97de1d1692777186b2ce902b4d\">distortion</span> </strong><strong>(Statement-2)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP485\" data-author=\"\" data-hash=\"7048\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/FRdwxXOXAJzsIjUfzdsK1743682690.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP486\" data-author=\"\" data-hash=\"7049\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/9ghHIghpg8hdlGvjaRF51743682733.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>There is <span class=\"customMeta\" data-dictid=\"279228dffd1692777191c834a27177\">magnification</span> of the image. <strong>(Statement-3)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>There is a minification of the image. <strong>(Statement-4)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seen with <strong>convex lenses</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seen with <strong>concave lenses</strong>.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ZRlMaOaIEtinVW9uiFCH1747393429.mp3", "video": ""}, {"text": "A 45-year-old patient presents with blurry vision and difficulty focusing after undergoing cataract surgery 3 weeks ago. On examination, the patient has no lens in the eye and no evidence of intraocular lens (IOL) implantation. Which of the following is the most appropriate management for this patient?", "options": [{"label": "A", "text": "Prescribe corrective glasses with a high refractive index", "correct": false}, {"label": "B", "text": "Fit the patient with an intraocular lens", "correct": true}, {"label": "C", "text": "Perform a keratoplasty to correct vision", "correct": false}, {"label": "D", "text": "Initiate topical corticosteroids for inflammation", "correct": false}], "correct_answer": "B. Fit the patient with an intraocular lens", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Absence of <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens from the eye.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aetiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Congenital absence (rare)</li>\n<li>Surgical removal (common)</li>\n<li>Traumatic <span class=\"customMeta\" data-dictid=\"eccb8fb4c81692777187d7e3895081\">extrusion</span> of lens (rare)</li>\n<li>Posterior lens <span class=\"customMeta\" data-dictid=\"c1aae6e67f169277718624a4e51cfe\">dislocation</span> (optical aphakia)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optical Effects</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>High hypermetropia</li>\n<li>Reduced eye power to +44 D (from +60 D)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Defective vision (far and near)</li>\n<li><strong>Erythropsia and cyanopsia</strong> (abnormal red and blue color defect)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Limbal/corneal <span class=\"customMeta\" data-dictid=\"561a199cce1692777198225706434c\">scar</span> (in <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> cases)</li>\n<li>Deep <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</li>\n<li>Iridodonesis &amp; Jet-black pupil</li>\n<li><strong>Only 2 Purkinje images </strong>(normal: 4)</li>\n<li><strong>Hypermetropic small <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Correct <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> error with:</p>\n<ul>\n<li><strong>Spectacles:</strong> the problem of spherical <span class=\"customMeta\" data-dictid=\"78c3be64551692777180c154e476ad\">aberration</span> and roving <span class=\"customMeta\" data-dictid=\"4b7376b26e169277719769efef1e36\">ring scotoma</span> (jack-in-the-box phenomenon)</li>\n<li>Contact lenses</li>\n<li><strong>Intraocular lenses (IOL) - best method</strong></li>\n<li>Refractive LASIK surgery</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LDUQptkQn7spSXTSG9Rb1747233858.mp3", "video": ""}, {"text": "In the case of astigmatism, the vertical meridian is more curved than the horizontal. What kind of lens should be given?", "options": [{"label": "A", "text": "Concave cylindrical lens at 180°", "correct": true}, {"label": "B", "text": "Convex cylindrical lens at 180", "correct": false}, {"label": "C", "text": "Concave cylindrical lens at 90", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Concave cylindrical lens at 180°", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With-the-Rule <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">Astigmatism</span> (WTR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Against-the-Rule <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">Astigmatism</span> (ATR)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The vertical <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is more curved than the horizontal.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Correction requires a<strong> <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 180°</strong> or a <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 90°.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>It is called \"with-the-rule\" because the vertical <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is normally more <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> than the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> due to <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> pressure.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is more curved than the vertical meridian.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li>Correction requires a <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 180° or a <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 90°.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/x6L4kXCigpD1ToxwZROZ1747233641.mp3", "video": ""}, {"text": "A few rays of light are focused on the retina in one meridian and a few others are focused in front of the retina in another meridian. What is the diagnosis?", "options": [{"label": "A", "text": "Simple myopic astigmatism", "correct": true}, {"label": "B", "text": "Simple hypermetropic astigmatism", "correct": false}, {"label": "C", "text": "Mixed astigmatism", "correct": false}, {"label": "D", "text": "Compound myopic astigmatism", "correct": false}], "correct_answer": "A. Simple myopic astigmatism", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/frh615w2fFKNTVYRxMzI1743682511.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Regular Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Refractive power changes uniformly from one <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> to another. There are 2 principal meridians.</li>\n</ul>\n<ul>\n<li>Oblique Astigmatism- two principal meridians are not <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> and vertical but are at right angles to each other (e.g., 45° and 135°).</li>\n<li>Bioblique Astigmatism- two principal meridians are not at right angles to each other (e.g., one at 30° and the other at 100°).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Irregular Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Irregular change in <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> power in different meridians, with multiple meridians that do not admit geometrical analysis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hIHZ3hQE29vInT5JxjuQ1747233400.mp3", "video": ""}, {"text": "A 35-year-old patient presents with difficulty focusing on both near and distant objects. Examination reveals high hypermetropia. What is the expected fundoscopy finding", "options": [{"label": "A", "text": "Smaller optic disc", "correct": false}, {"label": "B", "text": "Shotsilk retina", "correct": false}, {"label": "C", "text": "Pseudopapillitis", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Axial Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Shortening of the eyeball's <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> length. Commonest form.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Curvatural Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flatter <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the cornea, lens, or both.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Index Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreased <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> index of the lens, usually due to <span class=\"customMeta\" data-dictid=\"721937292f1692777185048f04ce29\">cortical</span> <span class=\"customMeta\" data-dictid=\"dae4dea0581692777198fdef9fa684\">sclerosis</span> in old age or in treated diabetics.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Positional Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Posterior <span class=\"customMeta\" data-dictid=\"5a50cd774d1692777186c56ec68eac\">displacement</span> of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Aphakia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absence of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens, either <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> or <span class=\"customMeta\" data-dictid=\"0f0b2969921692777180de24f0b0c0\">acquired</span> (e.g., after surgery), leads to high hypermetropia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Consecutive Hypermetropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Overcorrected <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> after <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> surgery (e.g., LASIK, ICL) or underpowered <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> lens (IOL) after <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> surgery.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6iUK9JPC6Ewg8OtmFcEa1747233187.mp3", "video": ""}, {"text": "A 65-year-old patient presents with gradually worsening blurry vision over the past year with recent improvement in his near vision . On examination, the lens shows yellowish discolouration with increased opacity, consistent with nuclear sclerosis. What kind of myopia has he developed secondary to this?", "options": [{"label": "A", "text": "Axial myopia ", "correct": false}, {"label": "B", "text": "Curvatural myopia ", "correct": false}, {"label": "C", "text": "Index myopia", "correct": true}, {"label": "D", "text": "Positional myopia", "correct": false}], "correct_answer": "C. Index myopia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Axial <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">Myopia</span> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase in the <span class=\"customMeta\" data-dictid=\"c12a40cc401692777181852b507764\">anteroposterior</span> length of the <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> (most common form).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Curvatural <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">Myopia</span> (Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the cornea, lens, or both.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Positional <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">Myopia</span> (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior placement of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens in the eye.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Index Myopia</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increase in the <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> index of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens, often due to nuclear sclerosis.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Myopia due to Excessive Accommodation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Caused by <span class=\"customMeta\" data-dictid=\"0338b655da16927771984b872baabb\">spasm</span> of accommodation, leading to excessive <span class=\"customMeta\" data-dictid=\"fefa53d9f216927772037e31a651d7\">focusing</span> power.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:550px\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Difficulty with far vision.</li>\n<li>Half-shutting of eyes for better clarity.</li>\n<li>Prominent eyeball.</li>\n<li>Prominent, large, and somewhat sluggishly reacting pupils.</li>\n<li>Slightly deeper <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</li>\n<li>Normal fundus; rarely a <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> myopic <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> may be seen.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prescription of appropriate <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> lenses.</li>\n<li>Surgical Treatment.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rkpgpqmxAnNHLb7DfxKP1747232971.mp3", "video": ""}, {"text": "Identify X:", "options": [{"label": "A", "text": "Angle alpha", "correct": false}, {"label": "B", "text": "Angle beta", "correct": false}, {"label": "C", "text": "Angle gamma", "correct": false}, {"label": "D", "text": "Angle kappa", "correct": true}], "correct_answer": "D. Angle kappa", "question_images": ["https://image.prepladder.com/notes/aZN926dxzxwJ9QU1PBEO1743682034.png"], "explanation_images": ["https://image.prepladder.com/notes/pT0CVT4a9HtjTDtQDEi51743682129.png", "https://image.prepladder.com/notes/ooTecW4d0PR1gTSCCBts1747243889.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Optic Axis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Passes through the center of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> (P), center of the lens (N), and meets the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> (R) on the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> side of the fovea.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Visual Axis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Line joining the <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> point (O), nodal point (N), and the <span class=\"customMeta\" data-dictid=\"82c2ec751816927772034d164bf755\">fovea</span> (F).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Fixation Axis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Line joining the <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> point (O) and the center of <span class=\"customMeta\" data-dictid=\"8342f520cf1692777197dee4e4e5c3\">rotation</span> of the eye (C).</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Angle Alpha (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Angle ANO is formed between the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> (AR) and visual <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> (OF) at the nodal point (N).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Angle Gamma (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Angle ACO is formed between the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> (AR) and <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> (OC) at the center of <span class=\"customMeta\" data-dictid=\"8342f520cf1692777197dee4e4e5c3\">rotation</span> (C).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Angle <span class=\"customMeta\" data-dictid=\"028f3db5b216927771903fc08eca2f\">Kappa</span> (Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Angle OPA formed between the visual <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> (OF) and pupillary line (AP).</li>\n<li>The center of the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> (P) is considered equivalent to the center of the pupil.</li>\n<li>Clinical significance:\n\t\t\t\t<ul>\n<li>Positive angle <span class=\"customMeta\" data-dictid=\"028f3db5b216927771903fc08eca2f\">kappa</span> causes pseudo-exotropia.</li>\n<li>Negative angle <span class=\"customMeta\" data-dictid=\"028f3db5b216927771903fc08eca2f\">kappa</span> causes pseudo-esotropia.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jPcgeYgMvkZ3wgviMnuL1747232598.mp3", "video": ""}, {"text": "Snellen chart is used to assess which of the following?", "options": [{"label": "A", "text": "Colour vision", "correct": false}, {"label": "B", "text": "Contrast sensitivity", "correct": false}, {"label": "C", "text": "Peripheral vision", "correct": false}, {"label": "D", "text": "Visual acuity", "correct": true}], "correct_answer": "D. Visual acuity", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/BLlTsjRHdT4pMLqh1ClZ1743665675.png", "https://image.prepladder.com/notes/o54f6yuSLXCVoM95ZN9X1743665600.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:647px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Snellen’s chart</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Measures visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> by assessing the eye's ability to distinguish details or separate points.</li>\n</ul>\n<p><img alt=\"OP454\" data-author=\"\" data-hash=\"6881\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/BLlTsjRHdT4pMLqh1ClZ1743665675.png\"/></p>\n\t\t\t \n\n\t\t\t<ul>\n<li>Rows of decreasing-sized letters fit within squares. Each letter subtends an angle of 5 minutes, and the lines forming letters subtend 1 minute of arc.</li>\n</ul>\n<p><img alt=\"OP455\" data-author=\"\" data-hash=\"6880\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/o54f6yuSLXCVoM95ZN9X1743665600.png\"/></p>\n<br/>\n\t\t\t </td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">Acuity</span> Notation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Snellen Fraction: Denoted as a fraction, with the numerator being 6 meters and the denominator indicating the distance at which normal vision reads the same letter (e.g., 6/18 means the patient reads at 6 meters what normal vision reads at 18 meters).</li>\n<li>Metric/Imperial: 6/6 = 20/20 vision.</li>\n<li>Decimal Acuity: 6/6 equals 1.0 decimal acuity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Testing Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The patient is positioned 6 meters from the chart, and each eye is tested individually, starting with the right eye. The patient reads the smallest visible letter.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Refractive Errors: Primarily measures uncorrected vision. Pinhole tests help detect <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors that can be corrected with lenses.</li>\n<li>Subjectivity: Dependent on patient literacy, language, and cognitive ability.</li>\n<li>Scope: Assesses only visual acuity, not contrast sensitivity, color vision, or <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> vision.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/78jS6JIUutoFxMwPKlGp1747122079.mp3", "video": ""}, {"text": "A 65-year-old patient with a mature cataract presents for an eye examination. During the assessment, the ophthalmologist observes the absence of a specific Purkinje image. Which Purkinje image is most likely to be absent in this case?", "options": [{"label": "A", "text": "First Purkinje image", "correct": false}, {"label": "B", "text": "Second Purkinje image", "correct": false}, {"label": "C", "text": "Third Purkinje image", "correct": false}, {"label": "D", "text": "Fourth Purkinje image", "correct": true}], "correct_answer": "D. Fourth Purkinje image", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/SiPthhJRVmhs0rAey5vu1743678496.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bgHFaIz2GrFB5PancGFI1747212560.mp3", "video": ""}, {"text": "Which of the following is the most sensitive test for both congenital and acquired colour vision defects?", "options": [{"label": "A", "text": "Ishihara Test", "correct": false}, {"label": "B", "text": "Farnsworth-Munsell 100 Hue Test", "correct": true}, {"label": "C", "text": "Hardy-Rand-Rittler (HRR) Test", "correct": false}, {"label": "D", "text": "Holmgren Wool Test", "correct": false}], "correct_answer": "B. Farnsworth-Munsell 100 Hue Test", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/kSc8nDLIRBR2wUpe1I4v1743678132.png", "https://image.prepladder.com/notes/klPyVVwQwOtlzRnouG3W1743678198.png", "https://image.prepladder.com/notes/QHPMdmwrBDbcS54ZdtO41743678268.png", "https://image.prepladder.com/notes/pLtf3gmY9Y5LcrrOJ2pH1743678336.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Mk3np0WZuOkCh5jm7D021747212160.mp3", "video": ""}, {"text": "A 40-year-old woman presents with a 3-day history of painful vision loss in her right eye. She has a history of multiple sclerosis. On examination, her visual acuity is 20/30 in the right eye, and a RAPD is noted. She reports difficulty distinguishing red and green colors in the right eye, but her left eye is normal on color vision testing. Which of the following is the most likely cause of her acquired color blindness?", "options": [{"label": "A", "text": "Retinal vein occlusion", "correct": false}, {"label": "B", "text": "Optic neuritis", "correct": true}, {"label": "C", "text": "Diabetic retinopathy", "correct": false}, {"label": "D", "text": "Macular degeneration", "correct": false}], "correct_answer": "B. Optic neuritis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/lJ5ohyYHBPi6S2r4dxtL1747211566.mp3", "video": ""}, {"text": "Which type of colour blindness is caused by the absence of green cones in the retina?", "options": [{"label": "A", "text": "Protanopia", "correct": false}, {"label": "B", "text": "Deuteranopia", "correct": true}, {"label": "C", "text": "Tritanopia", "correct": false}, {"label": "D", "text": "Achromatopsia", "correct": false}], "correct_answer": "B. Deuteranopia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trichromatic colour vision</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dichromatic colour vision</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Monochromatic colour vision</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The mechanism to appreciate all three primary colours is present but <span class=\"customMeta\" data-dictid=\"144d78fe4816927771852de984c62f\">defective</span> for one or two</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>One of the three primary colours is completely absent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Either have only one type of <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> or total colour blindness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Protanomalous</strong>: <span class=\"customMeta\" data-dictid=\"144d78fe4816927771852de984c62f\">Defective</span> red colour appreciation.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Deuteranomalous</strong>: <span class=\"customMeta\" data-dictid=\"144d78fe4816927771852de984c62f\">Defective</span> green colour appreciation.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Tritanomalous</strong>: <span class=\"customMeta\" data-dictid=\"144d78fe4816927771852de984c62f\">Defective</span> blue colour appreciation.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Protanopia</strong>: Complete red colour defect<strong>. </strong><strong>(Option A)</strong></li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Deuteranopia</strong>: Complete green colour defect.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Tritanopia</strong>: Absence of blue colour appreciation<strong>. </strong><strong>(Option</strong> <strong>C)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Cone monochromatism: </strong>Only one type of <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> presents with poor <span class=\"customMeta\" data-dictid=\"14fe46b522169277718547fccff221\">day vision</span> and normal night vision.</li>\n</ul>\n\t\t\t \n\n\t\t\t<ul>\n<li><strong>Rod monochromatism/ Achromatopsia: </strong>Total colour <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> with day blindness.</li>\n</ul>\n<p><strong>(Option D)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/muDmQUarJr8Ioxf0nxgX1747211158.mp3", "video": ""}, {"text": "At what age do infants typically begin to perceive and distinguish between different colors?", "options": [{"label": "A", "text": "At birth", "correct": false}, {"label": "B", "text": "1-2 months", "correct": false}, {"label": "C", "text": "3-4 months", "correct": true}, {"label": "D", "text": "6-9 months", "correct": false}], "correct_answer": "C. 3-4 months", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KCLn6RIUPI3PDRrfAi4P1747210931.mp3", "video": ""}, {"text": "A 55-year-old male presents with complaints of difficulty driving at night and reading in dim light, despite having normal visual acuity during his eye exam. He underwent cataract surgery six months ago but still experiences these visual issues. Which of the following tests is most appropriate to assess his current visual problem?", "options": [{"label": "A", "text": "Snellen Chart", "correct": false}, {"label": "B", "text": "Ishihara Test", "correct": false}, {"label": "C", "text": "Letter Contrast Sensitivity Test", "correct": true}, {"label": "D", "text": "Visual Field Test", "correct": false}], "correct_answer": "C. Letter Contrast Sensitivity Test", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/hnQh5fWdFpZ1GrbEj4NG1743677285.png", "https://image.prepladder.com/notes/NNm2JhF9bfG8GlavAiNl1743677229.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/GEjZS42YDkgcfR9h1jOH1747210495.mp3", "video": ""}, {"text": "A patient’s visual acuity improves significantly when looking through a small, opaque disc with a tiny hole, as shown in the image below. What is the likely cause of this improvement in visual acuity?", "options": [{"label": "A", "text": "Cataracts", "correct": false}, {"label": "B", "text": "Refractive error", "correct": true}, {"label": "C", "text": "Optic nerve damage", "correct": false}, {"label": "D", "text": "Macular degeneration", "correct": false}], "correct_answer": "B. Refractive error", "question_images": ["https://image.prepladder.com/notes/ujs4InURmOCvqTBOVr3B1743667644.png"], "explanation_images": ["https://image.prepladder.com/notes/ujs4InURmOCvqTBOVr3B1743667644.png", "https://image.prepladder.com/notes/ynmWP5x8a9eRhpszD1Q51743667578.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pinhole Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Stenopeic <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">Slit</span> Test</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses a small <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> disc with holes to reduce <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a24c7a76a516927771832d7d7e1a2c\">blur</span> and improve visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> in <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors up to 4D.</p>\n<p><img alt=\"OP467\" data-author=\"\" data-hash=\"6909\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ujs4InURmOCvqTBOVr3B1743667644.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses a narrow <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> to reduce <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> aberrations and enhance depth of focus.</p>\n<p><img alt=\"OP468\" data-author=\"\" data-hash=\"6908\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/ynmWP5x8a9eRhpszD1Q51743667578.png\"/></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"> </p>\n<p style=\"text-align: center;\"><strong>Clinical Applications</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Determines if <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> vision is due to <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors; vision improvement suggests a <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> issue.<strong> (Option B)</strong></li>\n<li>Quick assessment of visual acuity, often in under-resourced settings.</li>\n<li>WHO recommended <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> surveys.</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>To assess astigmatism, especially <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> (as it allows for a more detailed analysis of the patient's <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> by <span class=\"customMeta\" data-dictid=\"fefa53d9f216927772037e31a651d7\">focusing</span> light along a single axis) or complex visual issues.</li>\n<li>A <span class=\"customMeta\" data-dictid=\"ff6ffb032616927771994e40ee7dbe\">stenopeic</span> <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> is used in cases of corneal opacities to help identify the best location for an <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> iridectomy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Limitations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Can underestimate post-refractive visual acuity.</li>\n<li>Reduces light reaching the retina, potentially causing <span class=\"customMeta\" data-dictid=\"ad4c6b3e971692777186eb455dd56f\">diffraction</span> blur.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Limited mainly to complex <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> issues.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hDa2wWIVN6MfTG757sSS1747124531.mp3", "video": ""}, {"text": "Match the following visual acuity charts used to assess children of preschool age. 1) Allen test cards a) 2) HOTV test b) 3) Stycar Test c) 4) Cardiff Acuity test d)", "options": [{"label": "A", "text": "1-a; 2-b; 3-c; 4-d", "correct": true}, {"label": "B", "text": "1-a; 2-b; 4-c; 3-d", "correct": false}, {"label": "C", "text": "4-a; 2-b; 3-c; 1-d", "correct": false}, {"label": "D", "text": "1-a; 3-b; 2-c; 4-d", "correct": false}], "correct_answer": "A. 1-a; 2-b; 3-c; 4-d", "question_images": ["https://image.prepladder.com/notes/fyKwUYXj4SCP25fTkUSF1743666860.png", "https://image.prepladder.com/notes/5eNubMv6tlXqq8FYnXZx1743666895.png", "https://image.prepladder.com/notes/lA7ZIfsAP1xuGshVFfiq1743667366.png", "https://image.prepladder.com/notes/fjlc9Bg93MTM9f5gLLLO1743666536.png"], "explanation_images": ["https://image.prepladder.com/notes/fyKwUYXj4SCP25fTkUSF1743666860.png", "https://image.prepladder.com/notes/5eNubMv6tlXqq8FYnXZx1743666895.png", "https://image.prepladder.com/notes/lA7ZIfsAP1xuGshVFfiq1743667366.png", "https://image.prepladder.com/notes/fjlc9Bg93MTM9f5gLLLO1743666536.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:639px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> assessment- preschool</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1) <strong>Allen test cards</strong></p>\n<ul>\n<li>Designed for children aged 2 to 4 years.</li>\n<li>4 flashcards are used to test containing 7 <span class=\"customMeta\" data-dictid=\"9aab0c946a16927771984de0b70726\">schematic</span> figures.</li>\n<li>They are identified from different distances points</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>a)</strong><img alt=\"OP464\" data-author=\"\" data-hash=\"6900\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fyKwUYXj4SCP25fTkUSF1743666860.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2) <strong>HOTV test</strong></p>\n<ul>\n<li>Designed for children older than 4 years.</li>\n<li>Test involves identifying the letters “H,” “O,” “T,” and “V.”</li>\n<li>The letters decrease in size from the top to the bottom of the chart.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>b)</strong><img alt=\"OP465\" data-author=\"\" data-hash=\"6901\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/5eNubMv6tlXqq8FYnXZx1743666895.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3) <strong>Stycar Test</strong> (Screening Test for Young Children and Retarded)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>c)</strong><img alt=\"OP466\" data-author=\"\" data-hash=\"6907\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/lA7ZIfsAP1xuGshVFfiq1743667366.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4) <strong>Cardiff <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">Acuity</span> card test</strong></p>\n<ul>\n<li>The Cardiff <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">Acuity</span> Test is a vision assessment tool designed specifically for infants and young children (typically aged 6 months to 3 years) (Option C)</li>\n<li>Each card has the picture placed at either the top or the bottom.</li>\n<li>The child is shown a series of cards, and their eye movement is observed to see if they look in the direction of the picture (indicating they’ve seen it).</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>d)</strong><img alt=\"OP460\" data-author=\"\" data-hash=\"6896\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fjlc9Bg93MTM9f5gLLLO1743666536.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/djcXRSIKveJvLaYaS4j41747123769.mp3", "video": ""}, {"text": "Which among the following is used to check visual acuity in children less than 1 year? 1) 2) 3) 4)", "options": [{"label": "A", "text": "1 and 4", "correct": false}, {"label": "B", "text": "2 and 3", "correct": false}, {"label": "C", "text": "All except 4", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": ["https://image.prepladder.com/notes/fjlc9Bg93MTM9f5gLLLO1743666536.png", "https://image.prepladder.com/notes/RnZp52dNU9eEV3VmeBjF1743666569.png", "https://image.prepladder.com/notes/wtdG0i5C0yZ3iCYT8yS31743666604.png", "https://image.prepladder.com/notes/e6FFzDCNJK1YCF6r9na81743666644.png"], "explanation_images": ["https://image.prepladder.com/notes/fjlc9Bg93MTM9f5gLLLO1743666536.png", "https://image.prepladder.com/notes/RnZp52dNU9eEV3VmeBjF1743666569.png", "https://image.prepladder.com/notes/wtdG0i5C0yZ3iCYT8yS31743666604.png", "https://image.prepladder.com/notes/e6FFzDCNJK1YCF6r9na81743666644.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:358px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1) Cardiff <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">Acuity</span> test</strong></p>\n<ul>\n<li>\n<p>The Cardiff <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">Acuity</span> Test is a vision assessment tool designed specifically for infants and young children (typically aged 6 months to 3 years) (Option C)</p>\n</li>\n<li>\n<p>Each card has the picture placed at either the top or the bottom.</p>\n</li>\n<li>\n<p>The child is shown a series of cards, and their eye movement is observed to see if they look in the direction of the picture (indicating they’ve seen it).</p>\n</li>\n</ul>\n<p><img alt=\"OP460\" data-author=\"\" data-hash=\"6896\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fjlc9Bg93MTM9f5gLLLO1743666536.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2) Tellers chart</strong></p>\n<ul>\n<li>Utilises infants' natural tendency to look at patterns i.e., it is a preferential Looking Test.</li>\n<li>Suitable for infants</li>\n</ul>\n<p><img alt=\"OP461\" data-author=\"\" data-hash=\"6897\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/RnZp52dNU9eEV3VmeBjF1743666569.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3) Optokinetic Drum Test (OKN)</strong></p>\n<ul>\n<li>A rotating striped drum elicits <span class=\"customMeta\" data-dictid=\"42b110efe11692777190ea5720c867\">involuntary</span> eye movements.</li>\n<li>Adjusting the <span class=\"customMeta\" data-dictid=\"46eb4a312d169277719950b549eca4\">stripe</span> <span class=\"customMeta\" data-dictid=\"1b0d31fe811692777202644090ba60\">width</span> helps estimate visual acuity, especially for non-verbal children.</li>\n</ul>\n<p><img alt=\"OP462\" data-author=\"\" data-hash=\"6898\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/wtdG0i5C0yZ3iCYT8yS31743666604.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4) Visually evoked response test (VER)</strong></p>\n<ul>\n<li>Measures brain activity in response to visual stimuli</li>\n</ul>\n<p><img alt=\"OP462\" data-author=\"\" data-hash=\"6899\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/e6FFzDCNJK1YCF6r9na81743666644.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> assessment in children of different age groups</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infancy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1 to 2 years</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2 to 3 years</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3 to 5 years</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Catford drum test</li>\n<li>Fixation test</li>\n<li>OKNOVIS</li>\n<li>Teller <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> cards (Preferential looking test)</li>\n<li>Reflex response</li>\n<li>Visual evoked responses</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Boeck candy test</li>\n<li>Sheridan ball test</li>\n<li>Worth Ivory-ball test</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Coin test</li>\n<li>Dot visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> test</li>\n<li>Miniature toys test</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Landolt C</li>\n<li>Lea symbols chart</li>\n<li>Lippman’s HOTV test</li>\n<li>Sheridan letter test</li>\n<li>Tumbling E</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/aK7KXRIzIoITozCdKPfl1747209881.mp3", "video": ""}, {"text": "Which among the following is used to check visual acuity in illiterate adults? 1) 2) 3) 4)", "options": [{"label": "A", "text": "1 and 3", "correct": false}, {"label": "B", "text": "2 and 4", "correct": true}, {"label": "C", "text": "All except 1", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. 2 and 4", "question_images": ["https://image.prepladder.com/notes/BLlTsjRHdT4pMLqh1ClZ1743665675.png", "https://image.prepladder.com/notes/wXwclsdoMJO2RhUn80xs1743665908.png", "https://image.prepladder.com/notes/0dCs0susfDoj0MqckJ4T1743666017.png", "https://image.prepladder.com/notes/finb0ilB7hZfHYm4Vo7t1743666270.png"], "explanation_images": ["https://image.prepladder.com/notes/BLlTsjRHdT4pMLqh1ClZ1743665675.png", "https://image.prepladder.com/notes/wXwclsdoMJO2RhUn80xs1743665908.png", "https://image.prepladder.com/notes/0dCs0susfDoj0MqckJ4T1743666017.png", "https://image.prepladder.com/notes/finb0ilB7hZfHYm4Vo7t1743666270.png", "https://image.prepladder.com/notes/NEFExhFL7nUdRblrhqrv1743666405.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:696px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1) Snellen’s chart</strong></p>\n<ul>\n<li>Measures visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> by assessing the eye's ability to distinguish details or separate points.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP454\" data-author=\"\" data-hash=\"6881\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/BLlTsjRHdT4pMLqh1ClZ1743665675.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2) Tumbling \"E\" Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">Acuity</span> Chart</strong></p>\n<p> </p>\n<ul>\n<li>Involves <span class=\"customMeta\" data-dictid=\"75e8739695169277719138884fec36\">matching</span> the orientation of the letter \"E\" in different sizes.</li>\n<li>Used to check visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> illiterate. <strong>(Option B)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP456\" data-author=\"\" data-hash=\"6887\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/wXwclsdoMJO2RhUn80xs1743665908.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3) LOGMAR chart</strong></p>\n<ul>\n<li>LOGMAR is a refined method for measuring and expressing visual acuity, offering advantages over the traditional Snellen chart:\n\t\t\t\t<ul>\n<li><strong>Precision</strong>: LOGMAR charts are more sensitive and allow finer measurements compared to Snellen charts.</li>\n<li><strong>Tracking Changes</strong>: The consistent <span class=\"customMeta\" data-dictid=\"3c305b384216927771969ca4166493\">progression</span> aids in detecting subtle improvements or declines in vision.</li>\n<li><strong>Reliability</strong>: The standardized format and equally legible letters enhance measurement reliability.</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP457\" data-author=\"\" data-hash=\"6890\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/0dCs0susfDoj0MqckJ4T1743666017.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4) Landolt's broken ring test</strong></p>\n\t\t\t \n\n\t\t\t<p>The \"C\" is presented in various directions (top, bottom, left, or right), and the size of the \"C\" decreases progressively, similar to Snellen charts.</p>\n\t\t\t \n\n\t\t\t<p><strong>Procedure</strong>:</p>\n<ul>\n<li>The individual is shown on the chart from a standardized distance.</li>\n<li>For each \"C\" presented, they indicate the direction of the gap (either verbally or by pointing).</li>\n<li> </li>\n<li>The test continues until the individual can no longer accurately determine the gap’s direction.</li>\n<li>Used to check visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> in illiterate. <strong>(Option B)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP458\" data-author=\"\" data-hash=\"6894\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/finb0ilB7hZfHYm4Vo7t1743666270.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5) Jaeger chart</strong></p>\n<p>Gold standard for reading vision tests</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP459\" data-author=\"\" data-hash=\"6895\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/NEFExhFL7nUdRblrhqrv1743666405.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/FgRG7HDpEHaX4ftfNZZs1747122318.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 32 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Match the following images appropriately: 1.Streak Retinoscope a) 2. Priestly Smith Retinoscope b) 3.Trial Frame c) 4.Refraction Box d)", "options": [{"label": "A", "text": "1- a, 2- d, 3- c, 4- b", "correct": false}, {"label": "B", "text": "1- b, 2- c, 3- a, 4- d", "correct": false}, {"label": "C", "text": "1- c, 2- a, 3- d, 4- b", "correct": false}, {"label": "D", "text": "1- d, 2- c, 3- a, 4- b", "correct": true}], "correct_answer": "D. 1- d, 2- c, 3- a, 4- b", "question_images": ["https://image.prepladder.com/notes/IllfJfscVzxaZLXz7hKQ1742994117.png", "https://image.prepladder.com/notes/9o1z60UdSJ1yQCwaxn1g1742994186.png", "https://image.prepladder.com/notes/fO9Gmv9l7kAZbbKQ1g2g1742994057.png", "https://image.prepladder.com/notes/e6a9xL3zOhwNzMaILCkT1742993960.png"], "explanation_images": ["https://image.prepladder.com/notes/e6a9xL3zOhwNzMaILCkT1742993960.png", "https://image.prepladder.com/notes/fO9Gmv9l7kAZbbKQ1g2g1742994057.png", "https://image.prepladder.com/notes/IllfJfscVzxaZLXz7hKQ1742994117.png", "https://image.prepladder.com/notes/9o1z60UdSJ1yQCwaxn1g1742994186.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Aspect</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Image</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Streak Retinoscope:</strong></p>\n<ul>\n<li><strong>Type</strong>: Self-illuminated retinoscope.</li>\n<li><strong>Advantages</strong>: More sensitive than spot retinoscopy</li>\n<li>Spot <span class=\"customMeta\" data-dictid=\"34c5ba90691692777197c69ce07699\">retinoscope</span> produces a spot of light that can be made larger or smaller whereas streak <span class=\"customMeta\" data-dictid=\"34c5ba90691692777197c69ce07699\">retinoscope</span> produces a line or streak of light that can be rotated, made wider or narrower, or changed from <span class=\"customMeta\" data-dictid=\"dbce34504c1692777185e3a86451a0\">convergent</span> to <span class=\"customMeta\" data-dictid=\"85f32df9db169277718673128e6a9f\">divergent</span> light.</li>\n<li>for detecting astigmatism.</li>\n<li><strong>Popularity</strong>: More commonly used due to its enhanced ability to detect astigmatism.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Ismael Cordero\" data-hash=\"2104\" data-license=\"CC BY 2.0\" data-source=\"https://www.researchgate.net/figure/Retinoscope-components-streak-retinoscope_fig3_320625826\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/e6a9xL3zOhwNzMaILCkT1742993960.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Priestly Smith Retinoscope:</strong></p>\n<ul>\n<li><strong>Type</strong>: A specific type of mirror retinoscope.</li>\n<li><strong>Design</strong>: Combines plane and <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> mirrors.</li>\n<li><strong>Function</strong>: Provides better light control and enhances the accuracy of retinoscopy.</li>\n<li><strong>Cost</strong>: Generally inexpensive and commonly used.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"NA\" data-hash=\"2105\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/fO9Gmv9l7kAZbbKQ1g2g1742994057.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trial Frame:</strong></p>\n<ul>\n<li>Pre-requisite for retinoscopy.</li>\n<li>Adjustable type, suitable for use in both children and adults.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"Ajeeshkumar4u\" data-hash=\"2108\" data-license=\"CC BY-SA 4.0\" data-source=\"https://en.wikipedia.org/wiki/Ophthalmic_trial_frame#/media/File:Ophthalmic_trial_frame_3.jpg\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/IllfJfscVzxaZLXz7hKQ1742994117.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Refraction Box:</strong></p>\n<ul>\n<li>Contains a variety of spherical and cylindrical lenses with plus and minus powers.</li>\n<li>Includes a pinhole, occluder, and prisms.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"-\" data-author=\"NA\" data-hash=\"2112\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/9o1z60UdSJ1yQCwaxn1g1742994186.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8wHk5NBix0oMqadwlD6G1747052095.mp3", "video": ""}, {"text": "A patient presents with a spectacle prescription of -4.00 D sphere and +1.00 D cylinder at 90°. What is the transposed prescription?", "options": [{"label": "A", "text": "-3.00 D sphere -1.00 D cylinder at 180°", "correct": true}, {"label": "B", "text": "-5.00 D sphere -1.00 D cylinder at 90°", "correct": false}, {"label": "C", "text": "+4.00 D sphere -1.00 D cylinder at 90°", "correct": false}, {"label": "D", "text": "-1.00 D sphere +4.00 D cylinder at 180°", "correct": false}], "correct_answer": "A. -3.00 D sphere -1.00 D cylinder at 180°", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2A6Nfm33dSQ7Hm5CC2CI1747052304.mp3", "video": ""}, {"text": "A 38-year-old patient presents for an eye examination. During the duochrome test, the patient reports that they can see the red letters more clearly than the green letters. What is the most likely refractive error for this patient?", "options": [{"label": "A", "text": "Hyperopia", "correct": false}, {"label": "B", "text": "Myopia", "correct": true}, {"label": "C", "text": "Astigmatism", "correct": false}, {"label": "D", "text": "Presbyopia", "correct": false}], "correct_answer": "B. Myopia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Interpretation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Pinhole Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Confirms the accuracy of <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> in the trial frame</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The patient views through a pinhole aperture.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>An improvement in visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> while looking through a pin-hole indicates that <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> in the <span class=\"customMeta\" data-dictid=\"45cfb5c1bd169277720009490ff5fe\">trial frame</span> is incorrect.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Duochrome Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Refines the spherical component of the prescription</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The patient views red and green letters to check for <span class=\"customMeta\" data-dictid=\"d98477097716927771842c9ea0bbed\">chromatic</span> aberration.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clear red letters: </strong>Myopia; <strong>Clear green letters: </strong>Hypermetropia; <strong>Both clear:</strong> Emmetropia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Fogging Technique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Refines spherical <span class=\"customMeta\" data-dictid=\"92a52a7756169277718538d58fe1a9\">correction</span> (primarily for hypermetropia)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A strong <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> lens is added (+2D for myopia, +4D for hypermetropia), and then gradually <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> until full vision is regained.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Helps the patient <span class=\"customMeta\" data-dictid=\"c9001edbf216927771860f3475b44c\">differentiate</span> clarity, used to <strong>determine spherical correction</strong> but not <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LyLOAyqNO4oTa8TOW6Ao1747053609.mp3", "video": ""}, {"text": "A 30-year-old patient undergoes a refraction assessment, and the optometrist performs a Jackson Cross Cylinder (JCC) test to fine-tune the cylindrical correction. During the test, the patient reports that one of the orientations of the cylinder appears clearer than the other. What is the purpose of using the Jackson Cross Cylinder in this context?", "options": [{"label": "A", "text": "To determine the spherical refractive error", "correct": false}, {"label": "B", "text": "To measure the visual acuity at distance", "correct": false}, {"label": "C", "text": "To verify the axis and power of the cylindrical correction", "correct": true}, {"label": "D", "text": "To test for binocular vision and eye alignment", "correct": false}], "correct_answer": "C. To verify the axis and power of the cylindrical correction", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/lcHiS5Jb80JOdkyABMf21742990790.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Purpose</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Jackson Cross <span class=\"customMeta\" data-dictid=\"ba2a9140961692777185aae938c18b\">Cylinder</span> Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Verifies cylindrical power and axis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Uses ±0.25D or ±0.50D cross <span class=\"customMeta\" data-dictid=\"ba2a9140961692777185aae938c18b\">cylinder</span> to <span class=\"customMeta\" data-dictid=\"428b0fa6f316927771970a5763c505\">refine</span> <span class=\"customMeta\" data-dictid=\"ba2a9140961692777185aae938c18b\">cylinder</span> strength and axis.</li>\n<li>Adjusted based on vision improvement.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Astigmatic Fan Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Confirms cylindrical correction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A <span class=\"customMeta\" data-dictid=\"d9a87c19871692777186bdbb44bdca\">dial</span> with radiating lines at 10° intervals, known as an astigmatic fan is used.</li>\n<li>Some lines appear sharp in astigmatism.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> <span class=\"customMeta\" data-dictid=\"ba2a9140961692777185aae938c18b\">cylinder</span> is adjusted until all lines are equally sharp.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stenopaeic <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">Slit</span> Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Identifies astigmatic <span class=\"customMeta\" data-dictid=\"3c28fd47f71692777182efbbaa5f6d\">axis</span> and correction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A rotating <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> identifies the axis.</li>\n<li>The clearest vision occurs when the <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> aligns with the astigmatic axis.</li>\n<li>Not currently used.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/w79UYITWKOLZ2RcnAJy31747053832.mp3", "video": ""}, {"text": "A 25-year-old female with myopia is looking for contact lenses that will be comfortable for long hours of wear and require minimal maintenance. She is involved in outdoor activities and is seeking a lens that provides comfort, ease of use, and reduced risk of irritation over extended periods. Which type of contact lens would be most suitable for her?", "options": [{"label": "A", "text": "Hard contact lenses", "correct": false}, {"label": "B", "text": "Rigid gas permeable lenses", "correct": false}, {"label": "C", "text": "Soft contact lenses", "correct": true}, {"label": "D", "text": "PMMA lenses", "correct": false}], "correct_answer": "C. Soft contact lenses", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:642px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Contact Lens</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Material</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Properties</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Disadvantages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Usage</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hard Lenses</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>PMMA (polymethylmethacrylate)</p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> quality, durable, cheap.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Poor oxygen permeability- limited wearing time, hydrophobic, risk of corneal abrasions.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rarely used clinically.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>RGP Lenses</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Silicone acrylate, <span class=\"customMeta\" data-dictid=\"6f3ca6553416927771843c886c856b\">Cellulose</span> <span class=\"customMeta\" data-dictid=\"47765053a81692777180738f50cd4e\">acetate</span> <span class=\"customMeta\" data-dictid=\"e30faea02a1692777183c1bfa20c3c\">butyrate</span> (CAB)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oxygen permeable, hard.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>RGP lenses, unlike most soft contact lenses, must be fit to the individual patient’s eye, making this a more laborious process.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate use (\"semi-soft\" lenses).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Soft Lenses</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>HEMA (hydroxyethyl-methacrylate)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Soft, pliable, hydrophilic, oxygen permeable, comfortable and well tolerated.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Prone to protein deposits, cracking, and infections.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most frequently prescribed.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/IHTRZTOlG56fmFYb99MS1747054049.mp3", "video": ""}, {"text": "Which of the following is an absolute optical indication for contact lens use?", "options": [{"label": "A", "text": "Corneal ulcer", "correct": false}, {"label": "B", "text": "Bullous keratopathy", "correct": false}, {"label": "C", "text": "Unilateral aphakia", "correct": true}, {"label": "D", "text": "Aniridia", "correct": false}], "correct_answer": "C. Unilateral aphakia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/bYzmXee6xGOP1jvaw51j1747054694.mp3", "video": ""}, {"text": "A 7-year-old girl who had a H/0 congenital cataract is presenting with decreased vision in her right eye. Which type of amblyopia is most likely in this case?", "options": [{"label": "A", "text": "Strabismic amblyopia", "correct": false}, {"label": "B", "text": "Toxic amblyopia", "correct": false}, {"label": "C", "text": "Anisometropic amblyopia", "correct": false}, {"label": "D", "text": "Stimulus deprivation amblyopia", "correct": true}], "correct_answer": "D. Stimulus deprivation amblyopia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer:D) Stimulus &lt;span class=\"customMeta\" data-dictid=\"0a5bb4dd4116927771860470a5e991\"&gt;deprivation&lt;/span&gt; amblyopia</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Strabismic <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The brain suppresses input from one eye due to constant <span class=\"customMeta\" data-dictid=\"4d366430b5169277719914874d78a5\">squint</span> (strabismus).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common cause; underdevelopment of vision in the deviated eye.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stimulus <span class=\"customMeta\" data-dictid=\"0a5bb4dd4116927771860470a5e991\">Deprivation</span> <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hindered vision due to <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> from early life (e.g., <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> cataracts, ptosis<strong>)</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lack of visual <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> affects normal development.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anisometropic <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A significant difference in <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> error between eyes.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The brain favours the <span class=\"customMeta\" data-dictid=\"55436411c216927771846e318f45ce\">clearer</span> eye, leading to <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">amblyopia</span> in the other.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ametropic Amblyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High uncorrected <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors in both eyes.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bilateral; is less severe compared to other types.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Meridional Amblyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uncorrected <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> affecting specific visual meridians.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Affects one or both eyes depending on the <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> degree.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ItkyPxyPkLRY9d0teCnt1747064634.mp3", "video": ""}, {"text": "A 7-year-old child with amblyopia in the right eye is prescribed occlusion therapy. The optometrist recommends patching the sound left eye for a certain number of hours each day. What is the typical recommended duration of patching for effective treatment in children with amblyopia?", "options": [{"label": "A", "text": "1-2 hours per day", "correct": false}, {"label": "B", "text": "3-4 hours per day", "correct": false}, {"label": "C", "text": "4-6 hours per day", "correct": true}, {"label": "D", "text": "12 hours per day", "correct": false}], "correct_answer": "C. 4-6 hours per day", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KZJNUBMPTTh0wjtCG46p1747055316.mp3", "video": ""}, {"text": "A 7-year-old child is evaluated for binocular vision using a synoptophore. The child successfully perceives two different images simultaneously and can superimpose incomplete but similar images into a single complete image. Which grade of binocular single vision is demonstrated by this child?", "options": [{"label": "A", "text": "Grade I - Simultaneous Perception", "correct": false}, {"label": "B", "text": "Grade II - Fusion", "correct": true}, {"label": "C", "text": "Grade III - Stereopsis", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "B. Grade II - Fusion", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/ee1xrITEYTz70sCk2qMO1742991986.png", "https://image.prepladder.com/notes/o4PRtzkp5yiI41lF1T7S1742991986.png", "https://image.prepladder.com/notes/lobMom4Rifq99d1psgEi1742991986.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Grade I - Simultaneous Perception</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Grade II - Fusion</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Grade III - Stereopsis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Ability to see two dissimilar objects simultaneously.<strong> (Option A ruled out)</strong></li>\n<li>Tested by projecting different images to each eye (e.g., bird in one eye, cage in the other).</li>\n<li>Example: Seeing a bird inside a cage.</li>\n</ul>\n<p><img alt=\"-\" data-author=\"na\" data-hash=\"2051\" data-license=\"na\" data-source=\"na\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/ee1xrITEYTz70sCk2qMO1742991986.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Power to superimpose two incomplete but similar images into one complete image.</li>\n<li>Tested by manipulating eye convergence/ <span class=\"customMeta\" data-dictid=\"9e1f577dad16927771863e4feb90a8\">divergence</span> for positive and negative <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> ranges.</li>\n</ul>\n<p><img alt=\"--\" data-author=\"NA\" data-hash=\"2052\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/o4PRtzkp5yiI41lF1T7S1742991986.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<ul>\n<li>Ability to perceive depth (third dimension). <strong>(Option C ruled out)</strong></li>\n<li>Tested with <span class=\"customMeta\" data-dictid=\"9f101ee8b41692777199c078da285f\">stereopsis</span> slides using the synoptophore.</li>\n</ul>\n<p><img alt=\"-\" data-author=\"NA\" data-hash=\"2050\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/lobMom4Rifq99d1psgEi1742991986.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DrqW8xsxeQH4XATr8rg31747055576.mp3", "video": ""}, {"text": "Worth's Four Dot Test for a 6 y/o child reveals that the child sees two red and three green lights as shown below in the image. Based on the test result, what is the most likely diagnosis in this child?", "options": [{"label": "A", "text": "Binocular Single Vision", "correct": false}, {"label": "B", "text": "Left Eye Suppression", "correct": false}, {"label": "C", "text": "Right Eye Suppression", "correct": false}, {"label": "D", "text": "Diplopia", "correct": true}], "correct_answer": "D. Diplopia", "question_images": ["https://image.prepladder.com/notes/tEjdgqCU1vNL5y2wsOoH1742994305.png"], "explanation_images": ["https://image.prepladder.com/notes/OCkhyqKmrJFy9RQStrzw1742994675.png", "https://image.prepladder.com/notes/Uv4BWioUL11BJst9Yu7q1742994969.png", "https://image.prepladder.com/notes/BEsKmDh7qogMJ3hbN3eg1742995027.png", "https://image.prepladder.com/notes/MXWVUo1pT8euo5TBYjZX1742995079.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:641px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Name of the test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Results</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Worth’s Four Dot test</strong></p>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"NA\" data-hash=\"2121\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/OCkhyqKmrJFy9RQStrzw1742994675.png\"/></p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The patient wears a red lens on the right eye and a green lens on the left eye.</li>\n<li>They are shown a box with four lights: one red, two green, and one white.</li>\n<li>The patient is asked how many lights they see.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>All four lights: BSV (binocular single vision). <strong>(Option A ruled out)</strong></li>\n<li>All four lights with manifest squint: Harmonious ARC (anomalous <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> correspondence).</li>\n<li>Two red lights: Right eye suppression. <strong>(Option C ruled out)</strong></li>\n<li>Three green lights: Left eye suppression. <strong>(Option B ruled out)</strong></li>\n<li>Alternating red and green lights: Alternating suppression.</li>\n<li>Two red and three green lights: <strong>Diplopia</strong> (double vision).<strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4 <span class=\"customMeta\" data-dictid=\"6bb8c041fd169277719626a00309b1\">Prism</span> Base-out test</strong></p>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"NA\" data-hash=\"2125\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/Uv4BWioUL11BJst9Yu7q1742994969.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A 4-diopter base-out <span class=\"customMeta\" data-dictid=\"6bb8c041fd169277719626a00309b1\">prism</span> is placed in front of the eye suspected of having CSS or microtropia.</li>\n<li>The movement of both eyes is observed.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bifoveal <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> (normal <span class=\"customMeta\" data-dictid=\"eadd1d717a16927771833964224058\">binocular</span> vision)</strong>:</p>\n<ul>\n<li>Both eyes move to maintain <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> and converge to correct for the prism-induced diplopia.</li>\n</ul>\n<p><strong>Microtropia with suppression</strong>:</p>\n<ul>\n<li>When the <span class=\"customMeta\" data-dictid=\"6bb8c041fd169277719626a00309b1\">prism</span> is placed in front of the suppressed eye, no corrective eye movement is observed because the image falls within the <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> scotoma.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bagolini <span class=\"customMeta\" data-dictid=\"83b138c27e16927771993110e65f52\">striated</span> glass test</strong></p>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"NA\" data-hash=\"2129\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/BEsKmDh7qogMJ3hbN3eg1742995027.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Striated <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> are placed in front of each eye at 45° and 135°.</li>\n<li>The patient fixates on a single-point light source.</li>\n<li>Each eye sees an <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> streak of light perpendicular to the other</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>If the two streaks cross to <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> an 'X': BSV or harmonious ARC.</li>\n<li>If two lines are seen but don’t intersect: <span class=\"customMeta\" data-dictid=\"1458c330411692777186cd49bb6a30\">Diplopia</span> (double vision).</li>\n<li>If only one streak is seen: Suppression.</li>\n<li>If a gap is seen in one of the streaks: Central <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> <span class=\"customMeta\" data-dictid=\"a685fb1a5716927771982efa29a365\">scotoma</span> (CSS).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Synoptophore</strong></p>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"NA\" data-hash=\"2130\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/MXWVUo1pT8euo5TBYjZX1742995079.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The patient views pictures inserted in two tubes, each with an <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> system equivalent to a 6-meter distance.</li>\n<li>The images are moved to adjust for horizontal, vertical, and torsional misalignment.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Detects <span class=\"customMeta\" data-dictid=\"7b7c55fbdd16927771990b50bda606\">suppression</span> and ARC.</li>\n<li>Assesses <span class=\"customMeta\" data-dictid=\"eadd1d717a16927771833964224058\">binocular</span> function and misalignments in different positions of gaze.</li>\n<li>Helps plan surgery for <span class=\"customMeta\" data-dictid=\"4d366430b5169277719914874d78a5\">squint</span> by measuring and adjusting for misalignments in various gaze positions.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wEk1aBQq78sMfht4PkBg1747064413.mp3", "video": ""}, {"text": "A 32 y/o man with -14 D myopia presents for a consultation regarding refractive surgery. He is not a candidate for laser-based procedures due to thin corneas. Which of the following is the most appropriate surgical option for his condition?", "options": [{"label": "A", "text": "Phakic intraocular lens (IOL) implantation", "correct": true}, {"label": "B", "text": "Radial keratotomy (RK)", "correct": false}, {"label": "C", "text": "Clear lens extraction", "correct": false}, {"label": "D", "text": "Intracorneal ring (ICR) implantation", "correct": false}], "correct_answer": "A. Phakic intraocular lens (IOL) implantation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Refractive surgeries for myopia</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Incisional Method </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Radial Keratotomy (RK)</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Involves <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> cuts in the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> to flatten it, correcting myopia.</li>\n<li>Used for low to moderate <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (2-6 D).</li>\n<li><strong>No longer recommended</strong> due to the advent of safer procedures like LASIK.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Newer Methods</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Photorefractive Keratectomy (PRK) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>It uses an <span class=\"customMeta\" data-dictid=\"b29e14e78a1692777187e2ac5fccaf\">excimer laser</span> to reshape the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> by removing a thin corneal layer.</li>\n<li>Suitable for correcting <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -6 D.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Refractive Lenticule Extraction (SMILE)</strong>:</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A minimally <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> laser procedure where a small lenticule is removed to reshape the cornea.</li>\n<li>Effective for <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -10 D, with or without astigmatism.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intracorneal Rings (ICR)</strong>:</p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rings are inserted into the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> to flatten it and reduce <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> power.</li>\n<li>Results can be unpredictable, with risks such as corneal inflammation, so is not recommended</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Orthokeratology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>A non-surgical and <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> method involving rigid contact lenses worn overnight to reshape the cornea.</li>\n<li>Corrects <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -5 D temporarily.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>High <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">Myopia</span> Solutions </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clear Lens Extraction</strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Removal of the natural lens (without cloudiness) to correct very high <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (-16 D to -18 D).</li>\n<li>Less common now due to risks like <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phakic <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">Intraocular</span> Lens (IOL) Implantation</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Implantable lens placed without removing the natural lens.</li>\n<li><strong>Best for <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> exceeding -8 D, especially in patients unsuitable for laser surgery.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/7b99yQhXTpi5Ouamuq3s1747057105.mp3", "video": ""}, {"text": "A 30-year-old patient with a history of myopia is considering LASIK surgery. Which of the following is NOT an indication of the procedure?", "options": [{"label": "A", "text": "The patient’s refraction has been stable for the past 14 months", "correct": false}, {"label": "B", "text": "The patient is over 20 years old", "correct": false}, {"label": "C", "text": "Presence of corneal ectasia", "correct": true}, {"label": "D", "text": "Myopia of -7 D", "correct": false}], "correct_answer": "C. Presence of corneal ectasia", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/a0kFyIdoKpP4FrSmmnuh1742992412.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/RcxX4RTwA7YwEp7oC7Pd1747057618.mp3", "video": ""}, {"text": "Which of the following surgical procedures is most suitable for correcting hypermetropia up to +4D and allows for faster visual recovery?", "options": [{"label": "A", "text": "Photorefractive Keratectomy (PRK)", "correct": false}, {"label": "B", "text": "Conductive Keratoplasty (CK)", "correct": false}, {"label": "C", "text": "Laser Thermal Keratoplasty (LTK)", "correct": false}, {"label": "D", "text": "Laser in situ Keratomileusis (LASIK)", "correct": true}], "correct_answer": "D. Laser in situ Keratomileusis (LASIK)", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:550px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Suitability</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>LASIK</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Moderate <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> (up to +4D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Faster recovery, more comfortable than PRK.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Surface <span class=\"customMeta\" data-dictid=\"eb788615bd16927771803d3841aa78\">Ablation</span> (PRK) </strong><strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low to moderate hypermetropia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Longer <span class=\"customMeta\" data-dictid=\"9cf83937931692777188a014337dcf\">healing</span> time, possible regression.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Laser <span class=\"customMeta\" data-dictid=\"e316517c941692777200eb2671128d\">Thermal</span> <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">Keratoplasty</span> (LTK) </strong></p>\n<p><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low degrees of hypermetropia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Effectiveness may diminish over time.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Suitability</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Conductive Keratoplasty</strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Radiofrequency energy heats and shrinks <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> fibres in the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> cornea, increasing corneal curvature.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Low to moderate hyperopia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May require repeat procedures; non-permanent.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/zGhsDn326FLkzuaeU4pQ1747058060.mp3", "video": ""}, {"text": "A 45 y/o patient presents with difficulty in reading and blurred vision. An eye examination reveals astigmatism. Based on the classification of astigmatism, which of the following statements is accurate?", "options": [{"label": "A", "text": "In With-the-Rule (WTR) astigmatism, the horizontal meridian has greater curvature than the vertical meridian.", "correct": false}, {"label": "B", "text": "Compound myopic astigmatism is characterized by both principal meridians focusing light in front of the retina.", "correct": true}, {"label": "C", "text": "Irregular astigmatism involves a predictable pattern of refractive power changes along the meridians.", "correct": false}, {"label": "D", "text": "Bi-oblique astigmatism has principal meridians that are perpendicular to each other.", "correct": false}], "correct_answer": "B. Compound myopic astigmatism is characterized by both principal meridians focusing light in front of the retina.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pxymFP38P2lgMfMuFpYe1742995900.png", "https://image.prepladder.com/notes/Z9xciBEZXMKLzbgXI0Np1742995945.png", "https://image.prepladder.com/notes/qOPwR6zCY8YGShwCwkTi1742995982.png", "https://image.prepladder.com/notes/rE0EDU1Oy5rhi6AjpYMa1742996022.png", "https://image.prepladder.com/notes/ouYzveE8iOCVPj5qyErx1742996070.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:542px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>With-the-Rule (WTR) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The vertical <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> has greater <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> than the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> meridian. <strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Against-the-Rule (ATR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is more curved than the vertical meridian.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oblique Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Principal meridians are at <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> angles (e.g., 45° and 135°), still perpendicular to each other.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bi-oblique Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Principal meridians are not perpendicular to each other (e.g., 30° and 100°). <strong>(Option D ruled out)</strong></p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:525px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Simple Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>One <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> focuses on the retina; the other focuses in front (simple myopic) or behind (simple hypermetropic).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Compound Astigmatism</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Both meridians focus light either in front (compound myopic) or behind (compound hypermetropic) the retina.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mixed Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>One <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> focuses in front of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> (myopic), and the other behind (hypermetropic).</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Concept</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Representation of Light Refraction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light rays are refracted by the cornea/lens into a <span class=\"customMeta\" data-dictid=\"61120eae1d16927771856f4782759a\">conoid</span> shape, not a single point.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Two <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">Focal</span> Lines</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Light focuses on two perpendicular lines (primary and secondary <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> lines) in an astigmatic eye.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Circle of Least Confusion (CoLC)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The area between <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> lines with the sharpest image.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Corrective Lenses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spherical lenses align the CoLC with the retina; cylindrical lenses correct <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> by straightening the conoid.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/8a8dq5XBVFbFTJFZnvu61747063903.mp3", "video": ""}, {"text": "A 25-year-old patient presents with blurred vision and headaches. On examination, the patient is found to have regular astigmatism with the following prescription: Sphere: +2.00 D, Cylinder: -1.50 D, Axis: 90°.What is the refractive power of the eye along the 90° meridian?", "options": [{"label": "A", "text": "+2.00 D", "correct": true}, {"label": "B", "text": "+0.50 D", "correct": false}, {"label": "C", "text": "+3.50 D", "correct": false}, {"label": "D", "text": "+1.25 D", "correct": false}], "correct_answer": "A. +2.00 D", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PP5CYbP5V6hpIV5xag1U1747064142.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 25 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - 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Pediatric pseudophakia", "question_images": ["https://image.prepladder.com/content/l8S04apZsKdQH0dp3cCk1695197797.png"], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Type of Lens</strong></p>\n</td>\n<td>\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Spherical Lenses</p>\n</td>\n<td>\n<p>Have a uniform <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> across the entire surface. They are used to correct <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors like <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> and hypermetropia.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Cylindrical Lenses</p>\n</td>\n<td>\n<p>Have different curvatures in different meridians. They are used to correct astigmatism, a condition where the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> has an <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> shape.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Bifocal Lenses</p>\n</td>\n<td>\n<p>Contain two different <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> powers in a single lens. They are used to correct presbyopia, a condition where the ability to focus on near objects decreases with age.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Trifocal Lenses</p>\n</td>\n<td>\n<p>Contain three different <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> powers in a single lens. They are used to correct <span class=\"customMeta\" data-dictid=\"c95deaf12816927771968460e083bc\">presbyopia</span> and provide clear vision at varying distances, including near, intermediate, and far.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Progressive Lenses</p>\n</td>\n<td>\n<p>Provide a gradual transition of <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> powers from the top (distance vision) to the bottom (near vision) of the lens. They are used to correct <span class=\"customMeta\" data-dictid=\"c95deaf12816927771968460e083bc\">presbyopia</span> without visible lines on the lens.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Toric Lenses</p>\n</td>\n<td>\n<p>Specialized lenses used to correct astigmatism. They have different powers in different meridians and are designed to <span class=\"customMeta\" data-dictid=\"ed17327223169277719753b0e5d6b4\">rotate</span> and align in a specific orientation on the eye.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Intraocular Lenses (IOLs)</p>\n</td>\n<td>\n<p>Artificial lenses implanted inside the eye during <span class=\"customMeta\" data-dictid=\"781e6a5a991692777183252720baad\">cataract</span> surgery or to correct <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors. They replace the natural lens and can be monofocal, multifocal, or accommodating, providing improved vision at specific distances.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Contact Lenses</p>\n</td>\n<td>\n<p>Thin, curved lenses placed directly on the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> to correct <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors or as a <span class=\"customMeta\" data-dictid=\"ff63f91a5e16927771858327cda029\">cosmetic</span> accessory. They can be spherical, toric, multifocal, or specialized for various eye conditions.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Orthokeratology Lenses</p>\n</td>\n<td>\n<p>Specialized rigid gas-permeable contact lenses worn overnight to temporarily reshape the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> and correct <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors. They allow for clear vision during the day without the need for <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> or lenses.</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Prism Lenses</p>\n</td>\n<td>\n<p>Lenses with a <span class=\"customMeta\" data-dictid=\"6bb8c041fd169277719626a00309b1\">prism</span> prescription used to correct eye misalignment, reduce double vision, or assist with specific visual conditions. They bend light and help align images seen by each eye.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What would be the recommended treatment for simple myopic astigmatism among the following options?", "options": [{"label": "A", "text": "+1.00 DS", "correct": false}, {"label": "B", "text": "-1.00 DC × 180 degree", "correct": true}, {"label": "C", "text": "-1.00 DS", "correct": false}, {"label": "D", "text": "-1.00 DS – 1.00 × 180 degree", "correct": false}], "correct_answer": "B. -1.00 DC × 180 degree", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/BqGTZvHzdCbodJCzOOLl1695187945.png"], "explanation": "<p>Correct Option B: -1.00 DC × 180 deg\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td style=\"text-align:center\"><strong>Axis-I</strong></td>\n<td style=\"text-align:center\"><strong>Axis-II</strong></td>\n<td style=\"text-align:center\"><strong>Type of astigmatism </strong></td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Normal</td>\n<td style=\"text-align:center\">+</td>\n<td style=\"text-align:center\">Simple hypermetropic </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">Normal </td>\n<td style=\"text-align:center\">-</td>\n<td style=\"text-align:center\">Simple myopic </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">+</td>\n<td style=\"text-align:center\">+</td>\n<td style=\"text-align:center\">Compound hypermetropic </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">-</td>\n<td style=\"text-align:center\">-</td>\n<td style=\"text-align:center\">Compound myopic </td>\n</tr>\n<tr>\n<td style=\"text-align:center\">+</td>\n<td style=\"text-align:center\">-</td>\n<td style=\"text-align:center\">Mixed astigmatism </td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What would be the suitable course of action for managing a 15-year-old girl who is non-adherent to wearing spectacles for her myopic astigmatism?", "options": [{"label": "A", "text": "LASIK", "correct": false}, {"label": "B", "text": "Spherical equivalent spectacles", "correct": true}, {"label": "C", "text": "Femto LASIK", "correct": false}, {"label": "D", "text": "Implantable collamer lens", "correct": false}], "correct_answer": "B. Spherical equivalent spectacles", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer B - Spherical equivalent spectacles</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Optical</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li><strong>Spectacles:</strong> with cylindrical power correction/<strong> spherical equivalent <span class=\"customMeta\" data-dictid=\"d5820e63b51692777198586cf21457\">spectacles</span> </strong>is the initial treatment option especially for paediatric age group <strong>(Option B)</strong></li>\n<li><strong>Rigid contact lenses:</strong> for up to 3D</li>\n<li><strong>Toric contact lenses:</strong> for &gt; 3D <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> cases</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Refractive Procedures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Phototherapeutic keratectomy: </strong>Using excimer lens, for <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> astigmatism, can correct up to 3D</li>\n<li><strong>LASIK (Laser-Assisted <span class=\"customMeta\" data-dictid=\"96aaaa68ce1692777190096abe3c8a\">In Situ</span> Keratomileusis): </strong>can correct up to 5D</li>\n<li><strong>IOL implantation: </strong>Toric IOLs are preferred using Collamer lenses</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Surgical</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Penetrating or Deep <span class=\"customMeta\" data-dictid=\"95dc7047f41692777191f225afb261\">Lamellar</span> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> <span class=\"customMeta\" data-dictid=\"9810f0dbdb16927771908a955add6d\">Keratoplasty</span> (DLAK):</strong> in cases of corneal scarring/ no improvement with other treatment modalities</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In the image provided, which refractive error is observed in the depicted condition?", "options": [{"label": "A", "text": "A condensing lens is not required", "correct": false}, {"label": "B", "text": "B) It is used as close to the patient’s eye as possible. A real, inverted image is seen, Magnification is about 15 times", "correct": false}, {"label": "C", "text": "A real, inverted image is seen", "correct": false}, {"label": "D", "text": "Magnification is about 15 times", "correct": true}], "correct_answer": "D. Magnification is about 15 times", "question_images": ["https://image.prepladder.com/content/0o5ng07v1egaHTnFDhvl1746104432.png"], "explanation_images": ["https://image.prepladder.com/content/AdUbNcws3bUBqAJjTmm61746104471.png", "https://image.prepladder.com/content/k94BafnIIiBD4FGkSiz21746104471.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Direct Ophthalmoscope</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Indirect Ophthalmoscope</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Virtual image, erect <strong>(Option B &amp; C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Real image, inverted</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Magnification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>15x <span class=\"customMeta\" data-dictid=\"279228dffd1692777191c834a27177\">magnification</span> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2-3x magnification</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Condensing lens</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Used <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Not required</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Visualization</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Uniocular</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Binocular</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Field of view</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>2 DD</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>8 DD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Advantages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Undilated pupil</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Stereopsis present</li>\n<li>Entire <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> can be seen</li>\n<li>Visualization through hazy media is possible</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"James Heilman, MD \" data-hash=\"\" data-license=\"Open access\" data-source=\"https://en.wikipedia.org/wiki/Ophthalmoscopy#/media/File:Ophthalmoscope_Otoscope08.JPG\" data-tags=\"\" height=\"437\" src=\"https://image.prepladder.com/content/AdUbNcws3bUBqAJjTmm61746104471.png\" width=\"198\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Sun.Y.Lee \" data-hash=\"\" data-license=\"NA\" data-source=\"https://eyewiki.org/File:AA0_52689.jpg\" data-tags=\"\" height=\"288\" src=\"https://image.prepladder.com/content/k94BafnIIiBD4FGkSiz21746104471.png\" width=\"362\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following lenses would be recommended to correct myopia?", "options": [{"label": "A", "text": "Convex", "correct": false}, {"label": "B", "text": "Concave", "correct": true}, {"label": "C", "text": "Cylindrical", "correct": false}, {"label": "D", "text": "Abraham lens", "correct": false}], "correct_answer": "B. Concave", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/OWWFTmI1wR4x9CQmRLpM1747914231.png", "https://image.prepladder.com/notes/Ke64BVFM4u9kx3VtA8Ur1747914193.png", "https://image.prepladder.com/notes/Ulm1GwSX886D6kNO4CxF1747914285.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>General measures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Balanced diet</li>\n<li>Visual hygiene: Posture correction, adequate illumination, reducing usage of video display units (VDUs)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Optical</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Concave lenses</strong> are prescribed: Spectacles/ contact lenses <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Surgical</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Radial Keratotomy (RK): </strong></p>\n<ul>\n<li>Used for low to moderate <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (2-6 D).</li>\n<li>No longer recommended due to the advent of safer procedures like LASIK.</li>\n</ul>\n<p> </p>\n<p><strong>Photorefractive Keratectomy (PRK): </strong></p>\n<ul>\n<li>It uses an <span class=\"customMeta\" data-dictid=\"b29e14e78a1692777187e2ac5fccaf\">excimer laser</span> to reshape the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> by removing a thin corneal layer.</li>\n<li>Suitable for correcting <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -6 D.</li>\n</ul>\n<p> </p>\n<p><strong>Refractive Lenticule Extraction (SMILE):</strong></p>\n<ul>\n<li>A minimally <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> laser procedure where a small lenticule is removed to reshape the cornea.</li>\n<li>Effective for <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -10 D, with or without astigmatism.</li>\n</ul>\n<p> </p>\n<p><strong>Phakic Intraocular Lens (IOL) Implantation:</strong></p>\n<ul>\n<li>Implantable lens placed without removing the natural lens.</li>\n<li>Best for <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> exceeding -8 D, especially in patients unsuitable for laser surgery.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a 3-year-old child who has recently developed 15-degree accommodative esotropia, what is the most effective treatment approach?", "options": [{"label": "A", "text": "Orthoptic exercise", "correct": false}, {"label": "B", "text": "Surgery", "correct": false}, {"label": "C", "text": "Refractive correction", "correct": true}, {"label": "D", "text": "INTACS", "correct": false}], "correct_answer": "C. Refractive correction", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/DSz4gqkHGV0KhBcFWgG11745925404.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:719px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Accommodative <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">Refractive</span> Esotropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Accommodative Non-refractive Esotropia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Accommodative Mixed Esotropia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Cause </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>High <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> (+4 to +7 D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Abnormal large AC/A (accommodative convergence/accommodation) ratio</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Combination of <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> and high AC/ A ratio</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Correction of <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> (spectacles) </strong></p>\n<p> </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Stamatis Gatzonis, V. Follidi\" data-hash=\"\" data-license=\"NA\" data-source=\"Figure 1 from The Influence of Compliance with the Use of Refractive Correction in Hyperopic Children on Accommodation | Semantic Scholar\" data-tags=\"\" height=\"208\" src=\"https://image.prepladder.com/content/DSz4gqkHGV0KhBcFWgG11745925404.png\" width=\"241\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Corrected by <strong>bifocal <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> with +3 DS </strong>added for near vision</li>\n<li>Miotics (Echothiophate)</li>\n<li>Surgery: Bilateral <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> recession</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Surgery: <strong>Bilateral <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> recession</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The probable cause for a patient with a corneal scar having a visual acuity of 6/36, which improves to 6/18 with a pinhole, is most likely due to...", "options": [{"label": "A", "text": "Glaucoma", "correct": false}, {"label": "B", "text": "Malingering", "correct": false}, {"label": "C", "text": "Irregular astigmatism", "correct": true}, {"label": "D", "text": "Cataract", "correct": false}], "correct_answer": "C. Irregular astigmatism", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/nrAjU7bTE3BghwYVg9VY1745922026.png", "https://image.prepladder.com/content/QVeS8ySc2aETSmprwRbG1745922051.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Pinhole Test</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Stenopeic <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">Slit</span> Test</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Uses a small <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> disc with holes to reduce <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a24c7a76a516927771832d7d7e1a2c\">blur</span> and improve visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> in <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors up to 4D.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Ajeeshkumar4u\" data-hash=\"\" data-license=\"CC BY-SA 4.0\" data-source=\"https://en.wikipedia.org/wiki/Pinhole_occluder#/media/File:Pinhole_occluder.jpg\" data-tags=\"\" height=\"342\" src=\"https://image.prepladder.com/content/nrAjU7bTE3BghwYVg9VY1745922026.png\" width=\"408\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Uses a narrow <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> to reduce <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> aberrations and enhance depth of focus.</p>\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"329\" src=\"https://image.prepladder.com/content/QVeS8ySc2aETSmprwRbG1745922051.png\" width=\"328\"/></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p> </p>\n<p><strong>Clinical Applications</strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Determines if <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> vision is due to <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors; vision improvement suggests a <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> issue.<strong> (Option C)</strong></li>\n<li>Quick assessment of visual acuity, often in under-resourced settings.</li>\n<li>WHO recommended <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> surveys.</li>\n</ul>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>To assess astigmatism, especially <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> (as it allows for a more detailed analysis of the patient's <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> by <span class=\"customMeta\" data-dictid=\"fefa53d9f216927772037e31a651d7\">focusing</span> light along a single axis) or complex visual issues.</li>\n<li>A <span class=\"customMeta\" data-dictid=\"ff6ffb032616927771994e40ee7dbe\">stenopeic</span> <span class=\"customMeta\" data-dictid=\"7fbb9ec5b716927771981c011f4299\">slit</span> is used in cases of corneal opacities to help identify the best location for an <span class=\"customMeta\" data-dictid=\"39020a9ff61692777194d4aca09c3b\">optical</span> iridectomy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Limitations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Can underestimate post-refractive visual acuity.</li>\n<li>Reduces light reaching the retina, potentially causing <span class=\"customMeta\" data-dictid=\"ad4c6b3e971692777186eb455dd56f\">diffraction</span> blur.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Limited mainly to complex <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> issues.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "During a routine eye examination, a patient's visual acuity was evaluated using Snellen's chart, and it was determined to be 6/6. What is the smallest angle at which this patient can differentiate two separate points or objects?", "options": [{"label": "A", "text": "15 minutes of arc", "correct": false}, {"label": "B", "text": "5 minutes of arc", "correct": true}, {"label": "C", "text": "10 minutes of arc", "correct": false}, {"label": "D", "text": "20 minutes of arc", "correct": false}], "correct_answer": "B. 5 minutes of arc", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/LhiDTXDJzhT9ABJVBeXH1745302635.png", "https://image.prepladder.com/notes/f9ctMFdIuDMI8SN02tMS1745302717.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:647px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Snellen’s chart</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Measures visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> by assessing the eye's ability to distinguish details or separate points.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Snellen’s chart\" data-author=\"Jeff Dahl\" data-hash=\"10866\" data-license=\"CC BY-SA 3.0\" data-source=\"https://en.wikipedia.org/wiki/Snellen_chart#/media/File:Snellen_chart.svg\" data-tags=\"April2025\" height=\"603\" src=\"https://image.prepladder.com/notes/LhiDTXDJzhT9ABJVBeXH1745302635.png\" width=\"400\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Rows of decreasing-sized letters fit within squares. Each letter subtends an angle of 5 minutes, and the lines forming letters subtend 1 minute of arc.</li>\n</ul>\n\t\t\t \n\n\t\t\t<p style=\"text-align:center\"><img alt=\"Snellen’s chart 2\" data-author=\"\" data-hash=\"10867\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" height=\"400\" src=\"https://image.prepladder.com/notes/f9ctMFdIuDMI8SN02tMS1745302717.png\" width=\"400\"/></p>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">Acuity</span> Notation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Snellen Fraction: Denoted as a fraction, with the numerator being 6 meters and the denominator indicating the distance at which normal vision reads the same letter (e.g., 6/18 means the patient reads at 6 meters what normal vision reads at 18 meters).</li>\n<li>Metric/Imperial: 6/6 = 20/20 vision.</li>\n<li>Decimal Acuity: 6/6 equals 1.0 decimal acuity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Testing Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The patient is positioned 6 meters from the chart, and each eye is tested individually, starting with the right eye. The patient reads the smallest visible letter.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Refractive Errors: Primarily measures uncorrected vision. Pinhole tests help detect <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors that can be corrected with lenses.</li>\n<li>Subjectivity: Dependent on patient literacy, language, and cognitive ability.</li>\n<li>Scope: Assesses only visual acuity, not contrast sensitivity, color vision, or <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> vision.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "When selecting the strength of an intraocular lens (IOL) for a child under 1 year old, what factors should be considered?", "options": [{"label": "A", "text": "Myopic shift", "correct": true}, {"label": "B", "text": "Hypermetropic shift", "correct": false}, {"label": "C", "text": "Length of the lens capsule", "correct": false}, {"label": "D", "text": "Growth of the lens capsule", "correct": false}], "correct_answer": "A. Myopic shift", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable medical condition for a 70-year-old individual who has relied on presbyopia glasses but can now comfortably read the newspaper without them?", "options": [{"label": "A", "text": "Index myopia", "correct": true}, {"label": "B", "text": "Index hypermetropia", "correct": false}, {"label": "C", "text": "Presbyopia", "correct": false}, {"label": "D", "text": "None of the above", "correct": false}], "correct_answer": "A. Index myopia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - Index myopia:</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type of Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cause</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Axial Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increase in the <span class=\"customMeta\" data-dictid=\"c12a40cc401692777181852b507764\">anteroposterior</span> length of the <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> (most common form).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Curvatural Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the cornea, lens, or both.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Positional Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anterior placement of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens in the eye.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Index Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Increase in the <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> index of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens, often due to nuclear sclerosis.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Myopia due to Excessive Accommodation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Caused by <span class=\"customMeta\" data-dictid=\"0338b655da16927771984b872baabb\">spasm</span> of accommodation, leading to excessive <span class=\"customMeta\" data-dictid=\"fefa53d9f216927772037e31a651d7\">focusing</span> power.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Clinical features </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Asthenopic symptoms</li>\n<li>Half-shutting of eyes for better clarity</li>\n<li>Prominent eyeball.</li>\n<li>Prominent, large, and somewhat sluggishly reacting pupils.</li>\n<li>Slightly deeper <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</li>\n<li>Normal fundus; rarely a <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> myopic <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> may be seen.</li>\n</ul>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Prescription of appropriate <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> lenses</li>\n<li>Surgical Treatment</li>\n</ul>\n</td>\n<td style=\"border-bottom:none; border-left:none; border-right:none; border-top:none\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following refractive errors is associated with the image given below?", "options": [{"label": "A", "text": "Presbyopia", "correct": false}, {"label": "B", "text": "Astigmatism", "correct": true}, {"label": "C", "text": "Hypermetropia", "correct": false}, {"label": "D", "text": "Myopia", "correct": false}], "correct_answer": "B. Astigmatism", "question_images": ["https://image.prepladder.com/notes/uRca3rtCN5JwuvQjsfA71745909935.png"], "explanation_images": ["https://image.prepladder.com/content/FoKtsEa0rsDCvdqhKDuq1745318252.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Regular Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Refractive power changes uniformly from one <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> to another. There are 2 principal meridians.\n\t\t\t\t<ul>\n<li>Oblique Astigmatism- two principal meridians are not <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> and vertical but are at right angles to each other (e.g., 45° and 135°).</li>\n<li>Bioblique Astigmatism- two principal meridians are not at right angles to each other (e.g., one at 30° and the other at 100°).</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Irregular Astigmatism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Irregular change in <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> power in different meridians, with multiple meridians that do not admit geometrical analysis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 21 year old boxer wanted to improve the vision . Which of the following surgery is contraindicated?", "options": [{"label": "A", "text": "RK", "correct": true}, {"label": "B", "text": "PRK", "correct": false}, {"label": "C", "text": "LASIK", "correct": false}, {"label": "D", "text": "SMILE", "correct": false}], "correct_answer": "A. RK", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Refractive surgeries for myopia</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Incisional Method </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Radial <span class=\"customMeta\" data-dictid=\"b054f6edd61692777190786ff1206f\">Keratotomy</span> (RK)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Involves <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> cuts in the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> to flatten it, correcting myopia.</li>\n<li>Used for low to moderate <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (2-6 D).</li>\n<li><strong>No longer recommended</strong> due to the advent of safer procedures like LASIK.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Newer Methods</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Photorefractive <span class=\"customMeta\" data-dictid=\"8a6b591d1d16927771900a3c620d92\">Keratectomy</span> (PRK) </strong></p>\n<p><strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>It uses an <span class=\"customMeta\" data-dictid=\"b29e14e78a1692777187e2ac5fccaf\">excimer laser</span> to reshape the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> by removing a thin corneal layer.</li>\n<li>Suitable for correcting <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -6 D.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Refractive Lenticule <span class=\"customMeta\" data-dictid=\"00456bf7d8169277718782edf9fa2c\">Extraction</span> (SMILE)</strong>:</p>\n<p><strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A minimally <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> laser procedure where a small lenticule is removed to reshape the cornea.</li>\n<li>Effective for <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -10 D, with or without astigmatism.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Intercorneal Rings (ICR)</strong>:</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Rings are inserted into the <span class=\"customMeta\" data-dictid=\"4cc4d657841692777185555e1b982d\">cornea</span> to flatten it and reduce <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> power.</li>\n<li>Results can be unpredictable, with risks such as corneal inflammation, so is not recommended</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Orthokeratology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>A non-surgical and <span class=\"customMeta\" data-dictid=\"a4488d66fc16927771975d043c4ccc\">reversible</span> method involving rigid contact lenses worn overnight to reshape the cornea.</li>\n<li>Corrects <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> up to -5 D temporarily.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>High <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">Myopia</span> Solutions </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clear Lens Extraction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Removal of the natural lens (without cloudiness) to correct very high <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (-16 D to -18 D).</li>\n<li>Less common now due to risks like <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Phakic <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">Intraocular</span> Lens (IOL) Implantation</strong></p>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Implantable lens placed without removing the natural lens.</li>\n<li><strong>Best for <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> exceeding -8 D, especially in patients unsuitable for laser surgery.</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient was prescribed with -1D spherical and -2D cylindrical at 180 degrees. What type of refractive error does this patient have?", "options": [{"label": "A", "text": "With the rule astigmatism", "correct": true}, {"label": "B", "text": "Against the rule astigmatism", "correct": false}, {"label": "C", "text": "Simple astigmatism", "correct": false}, {"label": "D", "text": "Mixed astigmatism", "correct": false}], "correct_answer": "A. With the rule astigmatism", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>With-the-Rule <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">Astigmatism</span> (WTR)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Against-the-Rule <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">Astigmatism</span> (ATR)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The vertical <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is more curved than the horizontal.</li>\n</ul>\n<p> </p>\n<ul>\n<li>Correction requires a<strong> <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 180° ± 20°</strong> or a <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 90° ± 20°.</li>\n</ul>\n<p> </p>\n<ul>\n<li>It is called \"with-the-rule\" because the vertical <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is normally more <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> than the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> due to <span class=\"customMeta\" data-dictid=\"819ddea9e51692777187cdff06b437\">eyelid</span> pressure.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> <span class=\"customMeta\" data-dictid=\"d2266722801692777192382c2b5902\">meridian</span> is more curved than the vertical meridian.</li>\n</ul>\n<p> </p>\n<ul>\n<li>Correction requires a <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 180° ± 20° or a <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> <span class=\"customMeta\" data-dictid=\"107a4b9e831692777185da7feffcac\">cylindrical lens</span> at 90° ± 20°.</li>\n</ul>\n<p> </p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>180 degrees</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>90 Degrees</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>With the rule </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>[-]</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>[+]</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Against the rule </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>[+]</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>[-]</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following do not represent the corrected refractive error?", "options": [{"label": "A", "text": "Myopia", "correct": false}, {"label": "B", "text": "Hyperopia", "correct": false}, {"label": "C", "text": "Presbyopia", "correct": true}, {"label": "D", "text": "Astigmatism", "correct": false}], "correct_answer": "C. Presbyopia", "question_images": ["https://image.prepladder.com/content/MK2ZYtOuwW3sNauDXfHk1747379027.png"], "explanation_images": ["https://image.prepladder.com/content/DPBSOYkagPpCSwY9xCtg1747379052.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Physiological <span class=\"customMeta\" data-dictid=\"80feaae4b31692777190ea1ba3fc25\">insufficiency</span> of <span class=\"customMeta\" data-dictid=\"c0682eacfc1692777180ad2c556c19\">accommodation</span> is typically associated with aging.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etio - Pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Age-related factors:</strong></p>\n<ul>\n<li>Decreased <span class=\"customMeta\" data-dictid=\"d6c754309d16927771874142ec8ca4\">elasticity</span> of the lens capsule.</li>\n<li>Sclerosis of the lens.</li>\n<li>Possible decline in <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle power.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Premature causes:</strong></p>\n<ul>\n<li>Uncorrected hypermetropia</li>\n<li>Chronic glaucoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Difficulty in near vision</li>\n<li>Asthenopic symptoms (eye fatigue)</li>\n<li>Intermittent diplopia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Options</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optical Treatment:</strong></p>\n<ul>\n<li>Convex <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> based on age</li>\n<li>Correct <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> error for distance first</li>\n<li>Types of Glasses: Unifocal, bifocal, or progressive (varifocal).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pharmacological therapy:1.25% Pilocarpine</strong>(FDA-approved)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Surgical options:</strong></p>\n<ul>\n<li>Conductive keratoplasty</li>\n<li>LASIK (Monovision/presbyopic multifocal-LASIK)</li>\n<li>Corneal inlays</li>\n<li>Multifocal <span class=\"customMeta\" data-dictid=\"ffac6924ab16927771907dbb6fd7dd\">IOL</span> placement following lens extraction</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What diagnosis is suggested by having different refractive powers (+5D in one eye and +1D in the other eye)?", "options": [{"label": "A", "text": "Refractive errors", "correct": false}, {"label": "B", "text": "Amblyopia", "correct": false}, {"label": "C", "text": "Anisometropic amblyopia", "correct": true}, {"label": "D", "text": "Malingering", "correct": false}], "correct_answer": "C. Anisometropic amblyopia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Strabismic <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The brain suppresses input from one eye due to constant <span class=\"customMeta\" data-dictid=\"4d366430b5169277719914874d78a5\">squint</span> (strabismus).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common cause; underdevelopment of vision in the deviated eye.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stimulus Deprivation <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hindered vision due to <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> from early life (e.g., <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> cataracts, ptosis, dense central <strong>corneal opacity)</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lack of visual <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> affects normal development.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Anisometropic <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong><strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A significant difference in <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> error between eyes.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The brain favours the <span class=\"customMeta\" data-dictid=\"55436411c216927771846e318f45ce\">clearer</span> eye, leading to <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">amblyopia</span> in the other.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ametropic Amblyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High uncorrected <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors in both eyes.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bilateral; is less severe compared to other types.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Meridional Amblyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uncorrected <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> affecting specific visual meridians.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Affects one or both eyes depending on the <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> degree.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is Anisometropia ?", "options": [{"label": "A", "text": "Difference in visual acuity", "correct": false}, {"label": "B", "text": "Difference in refractive error between 2 eyes", "correct": true}, {"label": "C", "text": "Difference in the axial length of the eyeball", "correct": false}, {"label": "D", "text": "Difference in size of eyeball", "correct": false}], "correct_answer": "B. Difference in refractive error between 2 eyes", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - Difference in &lt;span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\"&gt;refractive&lt;/span&gt; error between 2\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "During the Worth 4 Dot Test, a patient sees only three green dots. What is the likely diagnosis?", "options": [{"label": "A", "text": "Right eye suppression", "correct": true}, {"label": "B", "text": "Left eye suppression", "correct": false}, {"label": "C", "text": "Crossed diplopia with esodeviation", "correct": false}, {"label": "D", "text": "Crossed diplopia with exodeviation", "correct": false}], "correct_answer": "A. Right eye suppression", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Y3saRH5LSqzDuYL1cl0J1724830517.png"], "explanation": "<p>Correct Option A - Right eye su\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the term used to describe the refractive error seen in the ocular examination image of a 60-year-old patient who has complained of reduced distant vision, but no longer requires spectacles for near vision?", "options": [{"label": "A", "text": "Index myopia", "correct": true}, {"label": "B", "text": "Axial myopia", "correct": false}, {"label": "C", "text": "Curvatural myopia", "correct": false}, {"label": "D", "text": "Positional myopia", "correct": false}], "correct_answer": "A. Index myopia", "question_images": ["https://image.prepladder.com/notes/YounuuPRtEW3O6L1j8my1745909938.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Type of Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Cause</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Axial Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increase in the <span class=\"customMeta\" data-dictid=\"c12a40cc401692777181852b507764\">anteroposterior</span> length of the <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> (most common form).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Curvatural Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased <span class=\"customMeta\" data-dictid=\"4bd67d54f016927771850c953dadbc\">curvature</span> of the cornea, lens, or both.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Positional Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior placement of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens in the eye.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Index Myopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Increase in the <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> index of the <span class=\"customMeta\" data-dictid=\"35b1a3c6191692777185a1e2376fc0\">crystalline</span> lens, often due to nuclear sclerosis.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Myopia due to Excessive Accommodation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Caused by <span class=\"customMeta\" data-dictid=\"0338b655da16927771984b872baabb\">spasm</span> of accommodation, leading to excessive <span class=\"customMeta\" data-dictid=\"fefa53d9f216927772037e31a651d7\">focusing</span> power.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features </strong></p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Asthenopic symptoms</li>\n<li>Half-shutting of eyes for better clarity</li>\n<li>Prominent eyeball.</li>\n<li>Prominent, large, and somewhat sluggishly reacting pupils.</li>\n<li>Slightly deeper <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber.</li>\n<li>Normal fundus; rarely a <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> myopic <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> may be seen.</li>\n</ul>\n</td>\n</tr>\n<tr>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prescription of appropriate <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> lenses</li>\n<li>Surgical Treatment</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 22-year-old patient with high myopia and thick glasses presents with floaters in his eyes. What is the likely cause of this condition?", "options": [{"label": "A", "text": "Subarachnoid hemorrhage B) Retinal detachment C) Vitreous hemorrhage D) Branched retinal artery occlusion", "correct": false}, {"label": "B", "text": "Retinal detachment", "correct": true}, {"label": "C", "text": "Vitreous hemorrhage", "correct": false}, {"label": "D", "text": "Branched retinal artery occlusion", "correct": false}], "correct_answer": "B. Retinal detachment", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/OAMcRY1vAxaox78N2WkF1741276003.png", "https://image.prepladder.com/content/yvs61UR4BWPEXqWCj2001741276044.png", "https://image.prepladder.com/content/5wtYH6nV70I44GJnlOcp1741276079.png", "https://image.prepladder.com/content/cZfoFOrctt5mbnEiozHy1741276109.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pathological/degenerative/progressive <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> is a rapidly progressive error that starts in childhood at 5-10 years of age and results in high <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (&gt;-6D) during early adult life.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rapid <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> growth of the <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> outside normal biological variations</li>\n<li>Genetic factors (major role)\n\t\t\t\t<ul>\n<li>More common in women than men</li>\n<li>Autosomal dominant <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> myopia</li>\n<li>Heredity-\n\t\t\t\t\t<ul>\n<li>Familial, more common in women and in certain races</li>\n<li>Autosomal Dominant - <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to genes 18p11.31 and 12q21-23</li>\n<li>Sex-linked <span class=\"customMeta\" data-dictid=\"d54db2110416927771971e7c011a9f\">recessive</span> - high <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (&gt;6D)</li>\n</ul>\n</li>\n</ul>\n</li>\n<li>General growth process (minor role)\n\t\t\t\t<ul>\n<li>nutritional deficiency</li>\n<li>endocrine disturbances</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Defective vision with considerable failure in visual function</li>\n<li>Muscae volitantes (floaters)</li>\n<li>Difficulty in <span class=\"customMeta\" data-dictid=\"3a81134c8a16927771936151d6b34e\">night vision</span> in very high myopes with degenerative changes</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prominent eyeballs, often appear elongated</li>\n<li>Exophthalmos, especially in <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> cases</li>\n<li>Cornea is large</li>\n<li>The <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber is deep</li>\n<li>Pupils are slightly large and react sluggishly to light</li>\n<li>Fundus examination reveals:\n\t\t\t\t<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc appears large and pale</li>\n<li>Characteristic myopic crescent</li>\n<li>Tigroid fundus</li>\n<li>Myopic <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> (temporal to disc margin)</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Retinal <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> (Option B)</strong></li>\n<li>Complicated cataract</li>\n<li>Choroidal <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> and neovascularization</li>\n<li>Vitreous hemorrhage</li>\n<li>Primary open-angle <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> (associated condition)</li>\n<li>Degenerative changes in the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> and choroid:\n\t\t\t\t<ul>\n<li>Chorioretinal <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">atrophy</span> at the macula</li>\n<li><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1899\" src=\"https://image.prepladder.com/content/OAMcRY1vAxaox78N2WkF1741276003.png\" width=\"1999\"/></li>\n</ul>\n</li>\n</ul>\n<p> </p>\n<ul>\n<li>Foster-Fuchs spots</li>\n<li><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"1694\" src=\"https://image.prepladder.com/content/yvs61UR4BWPEXqWCj2001741276044.png\" width=\"1999\"/></li>\n</ul>\n<p> </p>\n<ul>\n<li>Lattice degeneration<strong> </strong></li>\n<li><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"243\" src=\"https://image.prepladder.com/content/5wtYH6nV70I44GJnlOcp1741276079.png\" width=\"554\"/></li>\n</ul>\n<p> </p>\n<ul>\n<li>Total <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> atrophy</li>\n</ul>\n<ul>\n<li>Posterior staphyloma<strong> </strong></li>\n<li><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"249\" src=\"https://image.prepladder.com/content/cZfoFOrctt5mbnEiozHy1741276109.png\" width=\"371\"/></li>\n</ul>\n<p> </p>\n<ul>\n<li>Degenerative changes in vitreous:\n\t\t\t\t<ul>\n<li>Liquefaction</li>\n<li>Vitreous opacities</li>\n<li>Posterior <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> detachment</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a cause of bilateral sudden painless loss of vision?", "options": [{"label": "A", "text": "Acute congestive glaucoma", "correct": false}, {"label": "B", "text": "Diabetic retinopathy", "correct": true}, {"label": "C", "text": "Keratoconus D) Iridocyclitis", "correct": false}, {"label": "D", "text": "Iridocyclitis", "correct": false}], "correct_answer": "B. Diabetic retinopathy", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/kZC8OrCaCAQk03K8qsYp1741790553.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not a suitable application for a stenopic slit?", "options": [{"label": "A", "text": "Fincham’s test", "correct": false}, {"label": "B", "text": "Corneal tattooing", "correct": true}, {"label": "C", "text": "Optical iridectomy", "correct": false}, {"label": "D", "text": "To find out the axis in astigmatism", "correct": false}], "correct_answer": "B. Corneal tattooing", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/aAi6a48437BWeYuaT2b01715236200.png"], "explanation": "<p>Correct Option B - Corneal tattooing\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "At a distance of 60 m, what is the measurement of the angle formed by the largest letter on Snellen's chart?", "options": [{"label": "A", "text": "5", "correct": true}, {"label": "B", "text": "30", "correct": false}, {"label": "C", "text": "50", "correct": false}, {"label": "D", "text": "10", "correct": false}], "correct_answer": "A. 5", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/wpq3s0W2X1WeLZ1LVQyL1715236536.png", "https://image.prepladder.com/content/EFbyjdVzY6JUxDXTJi1H1715236599.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A newborn is hypermetropic by", "options": [{"label": "A", "text": "+ 2.5 D", "correct": true}, {"label": "B", "text": "+ 5 D", "correct": false}, {"label": "C", "text": "+ 10 D", "correct": false}, {"label": "D", "text": "+ 1 D", "correct": false}], "correct_answer": "A. + 2.5 D", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What should be the power of prescription glasses for a 50-year-old man who is presbyopic?", "options": [{"label": "A", "text": "+1D", "correct": false}, {"label": "B", "text": "+2D", "correct": true}, {"label": "C", "text": "+3D", "correct": false}, {"label": "D", "text": "+4D", "correct": false}], "correct_answer": "B. +2D", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B: +2D\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the instrument.", "options": [{"label": "A", "text": "Maddox wing", "correct": false}, {"label": "B", "text": "Stenopic slit", "correct": false}, {"label": "C", "text": "Maddox rod", "correct": true}, {"label": "D", "text": "Phoropter", "correct": false}], "correct_answer": "C. Maddox rod", "question_images": ["https://image.prepladder.com/content/2u4EYeoCsIJSCVG8Hych1691506915.png"], "explanation_images": ["https://image.prepladder.com/content/BiWah2kFiYIFeO5QBstA1715248459.png", "https://image.prepladder.com/content/bRM4tsxztLFpJ0CQt4VY1715255144.png", "https://image.prepladder.com/content/l97XGNgnsCijaHvJeUTJ1715248484.png"], "explanation": "<p>Correct Option C - M\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What would be the recommended treatment for simple myopic astigmatism among the options provided?", "options": [{"label": "A", "text": "+1.00 DS", "correct": false}, {"label": "B", "text": "-1.00 DC × 180 Degree", "correct": true}, {"label": "C", "text": "-1.00 DS", "correct": false}, {"label": "D", "text": "-1.00DS – 1.00 DC × 180 Degree", "correct": false}], "correct_answer": "B. -1.00 DC × 180 Degree", "question_images": [], "explanation_images": [], "explanation": "<p>Correct option B: -1.00 DC × 180 Deg\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:575px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Axis I</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Axis II</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Type of Astigmatism</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Simple hypermetropic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Simple myopic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Compound hypermetropic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Compound myopic</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>+</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>-</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mixed</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not used to assess color vision?", "options": [{"label": "A", "text": "Holmgren wool test", "correct": false}, {"label": "B", "text": "Ishihara chart", "correct": false}, {"label": "C", "text": "FM 100 Hue test", "correct": false}, {"label": "D", "text": "Ames test", "correct": true}], "correct_answer": "D. Ames test", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Ames test: \n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Maximum visual field is seen in?", "options": [{"label": "A", "text": "Temporal", "correct": true}, {"label": "B", "text": "Nasal", "correct": false}, {"label": "C", "text": "Inferior", "correct": false}, {"label": "D", "text": "Superior", "correct": false}], "correct_answer": "A. Temporal", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - T\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In myopia, image is formed at:", "options": [{"label": "A", "text": "Anterior to retina", "correct": true}, {"label": "B", "text": "Posterior to retina", "correct": false}, {"label": "C", "text": "On retina", "correct": false}, {"label": "D", "text": "Uvea", "correct": false}], "correct_answer": "A. Anterior to retina", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\"&gt;Anterior&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What are the advantages of using contact lenses instead of eyeglasses?", "options": [{"label": "A", "text": "Less prismatic effect", "correct": true}, {"label": "B", "text": "Protection from UV rays", "correct": false}, {"label": "C", "text": "Decrease infection", "correct": false}, {"label": "D", "text": "Decrease inflammation", "correct": false}], "correct_answer": "A. Less prismatic effect", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Less &lt;span class=\"customMeta\" data-dictid=\"ebbe31bebf16927771969cb13b3b9e\"&gt;prismatic&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In myopia, an image is formed at?", "options": [{"label": "A", "text": "Anterior to retina", "correct": true}, {"label": "B", "text": "Posterior to retina", "correct": false}, {"label": "C", "text": "On retina", "correct": false}, {"label": "D", "text": "None", "correct": false}], "correct_answer": "A. Anterior to retina", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The test given below in the image is used for :", "options": [{"label": "A", "text": "Ocular deviation", "correct": false}, {"label": "B", "text": "Stereopsis test", "correct": true}, {"label": "C", "text": "Refractive errors", "correct": false}, {"label": "D", "text": "Colour Blindness", "correct": false}], "correct_answer": "B. Stereopsis test", "question_images": ["https://image.prepladder.com/content/SptD0ZGy93dv8lLSIIWE1695192718.png"], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"9f101ee8b41692777199c078da285f\"&gt;Stereopsis&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 43 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
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He had a recent upper respiratory infection. On examination, there is proptosis, restricted eye movement, and chemosis. Vision is intact. CT scan confirms orbital cellulitis. Which staging system is used to classify this condition?", "options": [{"label": "A", "text": "Chandler's classification", "correct": true}, {"label": "B", "text": "Van Herick classification", "correct": false}, {"label": "C", "text": "ETDRS classification", "correct": false}, {"label": "D", "text": "Shaffer grading", "correct": false}], "correct_answer": "A. Chandler's classification", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/l3PYQeExb2beybBfytmt1743669676.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Orbital cellulitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Orbital <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> is an <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <strong>infection of the soft tissues of the orbit</strong> located behind the <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Disc edema</li>\n<li>RAPD (Relative Afferent Pupillary Defect) due to <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve dysfunction</li>\n<li>Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</li>\n<li>CRAO (Central Retinal Artery Occlusion) or CRVO (Central Retinal Venous Occlusion)</li>\n<li>Generalized <span class=\"customMeta\" data-dictid=\"afd363657e16927771982285d861d6\">septicemia</span> or pyemia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>White cell count.</li>\n<li>Cultures: Blood, <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> discharge.</li>\n<li>X-ray PNS (sinusitis)</li>\n<li>High-resolution CT of the orbit, sinuses and brain (exclude a <span class=\"customMeta\" data-dictid=\"98c8f7f96f1692777199295afb1d35\">subperiosteal</span> or <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> abscess).</li>\n<li>MRI</li>\n<li>Lumbar <span class=\"customMeta\" data-dictid=\"9af4bb5919169277719688aaf3f8e7\">puncture</span> (if meningeal or cerebral signs develop).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Staging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Modified Chandler <span class=\"customMeta\" data-dictid=\"8ea2e3870f16927771990a138acbc1\">staging</span> </strong><strong>(Option A) </strong>system:</p>\n<ul>\n<li>Stage I: Preseptal cellulitis/ <span class=\"customMeta\" data-dictid=\"5b1b31d3e41692777195670afc94ca\">periorbital</span> <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> (limited <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> to <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum)</li>\n<li>Stage II: Inflammatory <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> oedema/ <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">Orbital</span> <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> (Posterior to <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum)</li>\n<li>Stage III: <span class=\"customMeta\" data-dictid=\"98c8f7f96f1692777199295afb1d35\">Subperiosteal</span> abscess</li>\n<li>Stage IV: <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">Orbital</span> abscess</li>\n<li>Stage V: Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</li>\n</ul>\n<img alt=\"OP295\" data-author=\"\" data-hash=\"6912\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/l3PYQeExb2beybBfytmt1743669676.png\"/><br/>\n\t\t\t </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Antibiotics (IV)</strong>\n<ul>\n<li>Empirical therapy treats <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> by giving Ceftazidime, Vancomycin, and Metronidazole.</li>\n</ul>\n</li>\n<li>Monitoring of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve function</li>\n<li><strong>Surgery</strong>\n<ul>\n<li>Drainage of an <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> or infected sinuses should be considered if there is a lack of response to antibiotics.</li>\n<li>Biopsy</li>\n<li>Severe <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve <span class=\"customMeta\" data-dictid=\"56af81fad316927771843d2b4b1e4f\">compression</span> may warrant an emergency canthotomy/ cantholysis</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 45-year-old patient presents with a large, painless orbital mass that has been causing progressive proptosis and visual disturbance. After imaging and biopsy, the mass is identified as malignant. What is the choice of treatment in this scenario, and what is its definition?", "options": [{"label": "A", "text": "Evisceration, it involves removal of the contents of the eyeball, sclera preserved", "correct": false}, {"label": "B", "text": "Enucleation, it involves removal of the contents of the eyeball, sclera preserved", "correct": false}, {"label": "C", "text": "Enucleation, it involves removal of the entire eyeball including the sclera.", "correct": false}, {"label": "D", "text": "Exenteration, it involves the removal of all orbital contents", "correct": true}], "correct_answer": "D. Exenteration, it involves the removal of all orbital contents", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Procedure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Extent of Removal</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cosmetic and Functional Outcomes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exenteration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> contents (Eyeball + EOM + eyelids)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant tumors, extensive disease</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Significant <span class=\"customMeta\" data-dictid=\"ff63f91a5e16927771858327cda029\">cosmetic</span> and functional deficits</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Evisceration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contents of the eyeball, <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> preserved</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not typically used for malignancy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preserves some eye movement</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Enucleation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Entire <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> including sclera</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Malignant tumours, less radical than exenteration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Allows for <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> <span class=\"customMeta\" data-dictid=\"17d0626681169277719604432b4d27\">prosthesis</span> placement</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 12-year-old patient presents to the OPD with a typical S-shaped deformity of the eyelid. On examination, the patient is found to have multiple café-au-lait spots and axillary freckling. Which of the following findings is most commonly observed in this condition?", "options": [{"label": "A", "text": "Early-onset cataracts", "correct": false}, {"label": "B", "text": "Lisch nodules", "correct": true}, {"label": "C", "text": "B/L Acoustic neuroma", "correct": false}, {"label": "D", "text": "Optic nerve sheath meningiomas", "correct": false}], "correct_answer": "B. Lisch nodules", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 6-year-old child presents with gradual, painless unilateral proptosis and vision loss. Fundoscopic examination reveals optic atrophy. Imaging studies show fusiform growth along the optic nerve. What is the most appropriate management for this child, considering the tumor is stationary and the vision is still present?", "options": [{"label": "A", "text": "Immediate surgical excision of the tumor", "correct": false}, {"label": "B", "text": "Radiotherapy to manage the tumor", "correct": false}, {"label": "C", "text": "Observation and regular monitoring", "correct": true}, {"label": "D", "text": "Chemotherapy as the first-line treatment", "correct": false}], "correct_answer": "C. Observation and regular monitoring", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ljY7WXJiuRbx7EoC4jLk1748001356.mp3", "video": ""}, {"text": "A 52-year-old woman presents with progressive, painless proptosis of the left eye and swelling in the temporal region of the face. On examination, she has boggy eyelid swelling, proptosis. A CT scan reveals hyperostosis of the sphenoid bone. Identify the false statement regarding the same.", "options": [{"label": "A", "text": "CT scan shows tubular enlargement of the optic nerve", "correct": false}, {"label": "B", "text": "They are more common in middle-aged women.", "correct": false}, {"label": "C", "text": "More common in NF II", "correct": false}, {"label": "D", "text": "They are slow-growing tumors from astrocytes in the optic nerve.", "correct": true}], "correct_answer": "D. They are slow-growing tumors from astrocytes in the optic nerve.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/aoZQsE2Aus9FmV8UBtOb1747991470.mp3", "video": ""}, {"text": "Which of the following is not part of the classical triad of Sturge-Weber syndrome?", "options": [{"label": "A", "text": "Port-wine stain (nevus flammeus) in the distribution of the trigeminal nerve", "correct": false}, {"label": "B", "text": "Secondary congenital glaucoma", "correct": false}, {"label": "C", "text": "Bilateral optic nerve glioma", "correct": true}, {"label": "D", "text": "Ipsilateral meningeal hemangiomatosis", "correct": false}], "correct_answer": "C. Bilateral optic nerve glioma", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sporadic <span class=\"customMeta\" data-dictid=\"d64938bfc81692777193fb87a47c80\">neurocutaneous</span> (phakomatosis) disorder</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gene involved</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Somatic activating <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> in the <strong>GNAQ</strong> gene</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Triad of SWS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <strong>Facial port-wine stain</strong> (in <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve distribution)</p>\n<p>2. <strong>Leptomeningeal angiomas</strong></p>\n<p>3. <strong>Ocular abnormalities</strong> (e.g. glaucoma)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Skin</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Port-wine <span class=\"customMeta\" data-dictid=\"b29a1a16ab1692777199ede1c6e28b\">stain</span> (nevus flammeus), typically in <strong>V1 (ophthalmic)</strong> division distribution</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CNS</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Leptomeningeal <span class=\"customMeta\" data-dictid=\"8ec3eb3bce1692777188bfd3eaa50f\">hemangiomatosis</span> → seizures, hemiparesis, intellectual disability</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eye</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glaucoma (due to increased <span class=\"customMeta\" data-dictid=\"d44bcb72461692777187bb7c5a4d1b\">episcleral</span> <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> pressure), <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> hemangioma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CT shows <strong>tram-track calcifications</strong>, <span class=\"customMeta\" data-dictid=\"7ce7bcb2f316927771938e0bea7f4d\">MRI</span> shows leptomeningeal enhancement</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Onset</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Usually in infancy, presenting with seizures or developmental delay</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antiepileptics, treatment of glaucoma, laser therapy for port-wine stain</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/o8kXHml9L42XUe6uDJMS1746454201.mp3", "video": ""}, {"text": "A 7-year-old male child presents with rapidly progressing proptosis in the right eye, which starts suddenly and mimics an acute inflammatory process. Imaging shows a well-defined orbital mass with adjacent bone destruction. What is the most common histopathological subtype of this tumor?", "options": [{"label": "A", "text": "Alveolar sarcoma", "correct": false}, {"label": "B", "text": "Embryonal sarcoma", "correct": true}, {"label": "C", "text": "Botryoid sarcoma", "correct": false}, {"label": "D", "text": "Spindle cell sarcoma", "correct": false}], "correct_answer": "B. Embryonal sarcoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/7ZZj323fXseybdME76051743670294.png", "https://image.prepladder.com/notes/HT7gLHJFOuCjxQGwZseY1743670314.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:389px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prevalence (%)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Embryonal <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>60%</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alveolar <strong>(Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>31%</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Botryoid <strong>(Option C ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>6%</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Spindle cells <strong>(Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3%</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anaplastic</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Rare</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/wvvWBzLTaakBtntcabcG1747990287.mp3", "video": ""}, {"text": "A 50-year-old woman presents with painless proptosis of the right eye for the past year. She denies any visual changes, pain, or other ocular symptoms. On examination, there is mild proptosis. MRI reveals a well-defined, intraconal mass with homogeneous enhancement, suggestive of a cavernous hemangioma. What is the most appropriate management for this patient?", "options": [{"label": "A", "text": "Surgical excision", "correct": false}, {"label": "B", "text": "Radiotherapy", "correct": false}, {"label": "C", "text": "Steroid injections", "correct": false}, {"label": "D", "text": "Observation and regular follow-up", "correct": true}], "correct_answer": "D. Observation and regular follow-up", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/9ATZq7TiVs2GogECsdNr1743670244.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which among the following statements is/are true regarding orbital varices? Proptosis worsens with the Valsalva maneuver. It is thin-walled distensible high-flow veins. Venous stasis can lead to the formation of phlebolith. Endovascular embolization is contraindicated.", "options": [{"label": "A", "text": "1 and 3", "correct": true}, {"label": "B", "text": "1, 3, and 4", "correct": false}, {"label": "C", "text": "Only 2", "correct": false}, {"label": "D", "text": "All of the above", "correct": false}], "correct_answer": "A. 1 and 3", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/6Vdn83Kx21bmE8MgkfIl1747989381.mp3", "video": ""}, {"text": "A 35-year-old man presents with a progressive painless swelling in the superolateral part of his left orbit over the past year. Examination reveals mild proptosis and downward and inward displacement of the eye. CT of the orbit shows a well-circumscribed, smooth, encapsulated mass in the lacrimal gland region. Excisional biopsy is shown below. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Adenoid cystic carcinoma", "correct": false}, {"label": "B", "text": "Squamous cell carcinoma", "correct": false}, {"label": "C", "text": "Pleomorphic adenoma", "correct": true}, {"label": "D", "text": "Lymphoma", "correct": false}], "correct_answer": "C. Pleomorphic adenoma", "question_images": ["https://image.prepladder.com/notes/cgD9mBCrRx0nOx8EWc821743670070.png"], "explanation_images": ["https://image.prepladder.com/notes/cgD9mBCrRx0nOx8EWc821743670070.png", "https://image.prepladder.com/notes/bfBiW286B44FNqm7d7IP1743670159.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HO3kAcdGHewTIqZ672Lw1747989052.mp3", "video": ""}, {"text": "Which is the most common non-epithelial malignant lacrimal gland tumor?", "options": [{"label": "A", "text": "Pleomorphic adeno-carcinoma", "correct": false}, {"label": "B", "text": "Adenoid cystic carcinoma", "correct": false}, {"label": "C", "text": "Lymphoma", "correct": true}, {"label": "D", "text": "Mucoepidermoid carcinoma", "correct": false}], "correct_answer": "C. Lymphoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/XKjzV4SLuM88NBuwx15u1743669886.png", "https://image.prepladder.com/notes/GyPaQYNMc87UrIsQRL6H1743669904.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:589px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most common <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> tumor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pleomorphic <span class=\"customMeta\" data-dictid=\"c3c9726266169277718021f4f0fa16\">adenoma</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most common <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">malignant</span> <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> tumor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adenoid <span class=\"customMeta\" data-dictid=\"38c41e122116927771859b63deb0ed\">cystic</span> <span class=\"customMeta\" data-dictid=\"988c19e3131692777183b6744d1920\">carcinoma</span> </strong><strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most common non-epithelial <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">malignant</span> <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> tumor</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lymphoma </strong><strong>(Option C)</strong></p>\n</td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>↳ Reference:</li><li>↳ Parsons diseases of the eye, 23rd edition, pg no 1105-06 Incidence, clinical features, and survival outcomes of primary malignant lacrimal gland tumors: A population‐based analysis - PMC (nih.gov)</li><li>↳ Parsons diseases of the eye, 23rd edition, pg no 1105-06</li><li>↳ Incidence, clinical features, and survival outcomes of primary malignant lacrimal gland tumors: A population‐based analysis - PMC (nih.gov)</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/n0beL66qkWAMTB9Jrjnm1747987947.mp3", "video": ""}, {"text": "A 45-year-old male presents with double vision, drooping of the right eyelid, and difficulty moving his right eye in multiple directions. On examination, the patient has normal visual acuity, ptosis, restricted eye movement, decreased sensation over the forehead, and absent corneal reflex on the same side. What is the most likely diagnosis and which cranial nerve is/are most likely affected in this condition?", "options": [{"label": "A", "text": "Superior orbital fissure syndrome; III, IV, V, and VI nerves", "correct": true}, {"label": "B", "text": "Orbital apex syndrome; optic nerve", "correct": false}, {"label": "C", "text": "Tolosa Hunt syndrome; II, III and IV nerves", "correct": false}, {"label": "D", "text": "Rochen-Duvigneaud syndrome; only III nerve", "correct": false}], "correct_answer": "A. Superior orbital fissure syndrome; III, IV, V, and VI nerves", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old male, recently recovered from COVID-19, presents with complaints of severe facial pain, nasal congestion, and black eschar on the left eye with periorbital pain. He has a history of uncontrolled diabetes mellitus. On examination, the following is seen. Which of the following is the most likely causative organism?", "options": [{"label": "A", "text": "Aspergillus species", "correct": false}, {"label": "B", "text": "Rhizopus species", "correct": true}, {"label": "C", "text": "Candida species", "correct": false}, {"label": "D", "text": "Cryptococcus neoformans", "correct": false}], "correct_answer": "B. Rhizopus species", "question_images": ["https://image.prepladder.com/notes/gX57SkdD9a2vxQuHodIR1748200841.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rhino <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">Orbital</span> Cerebral Mucormycosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Fungal infection (Mucoraceae, primarily <strong>Mucor</strong> and <strong>Rhizopus </strong>species). <strong>(Option B) </strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Risk factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Immunocompromised individuals</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Facial and <span class=\"customMeta\" data-dictid=\"5b1b31d3e41692777195670afc94ca\">periorbital</span> swelling, pain, proptosis, diplopia, fever. (similar to <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis)</li>\n<li>Tissue <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> (tissue ischemia)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/b7hGI1ZRxPfBfN8FO7ea1747986614.mp3", "video": ""}, {"text": "A 32-year-old male had blunt trauma to the face during a sports event. He reports difficulty moving his right eye upward and experiences double vision when looking up. On examination, there is tenderness at the right infraorbital rim, and the patient exhibits noticeable swelling and bruising around the right eye. Which wall of the orbit is most likely affected in this case?", "options": [{"label": "A", "text": "Medial wall", "correct": false}, {"label": "B", "text": "Lateral wall", "correct": false}, {"label": "C", "text": "Floor", "correct": true}, {"label": "D", "text": "Roof", "correct": false}], "correct_answer": "C. Floor", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/WCbmzhFnSwzUWBPEugEF1743666964.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NO8veO0hY6AwVjJNIoaO1747928583.mp3", "video": ""}, {"text": "A 10-year-old girl presents with a swollen, painful left eye that started after a recent cold. She is febrile and on examination, her left eyelid is erythematous and swollen, with chemosis, proptosis, limited ocular movement but normal visual acuity. What is the most common primary source of this eye infection in the child?", "options": [{"label": "A", "text": "Ethmoid sinusitis", "correct": true}, {"label": "B", "text": "Maxillary sinusitis", "correct": false}, {"label": "C", "text": "Frontal sinusitis", "correct": false}, {"label": "D", "text": "Otitis media", "correct": false}], "correct_answer": "A. Ethmoid sinusitis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Fm1m6hRKK4fIBMCBM2Hy1743669329.png", "https://image.prepladder.com/notes/7vkzTswceKBMOvNc6JAa1743669299.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Orbital cellulitis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Orbital <span class=\"customMeta\" data-dictid=\"0985f5f6041692777184d2e82e558c\">cellulitis</span> is an <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> <strong>infection of the soft tissues of the orbit</strong> located behind the <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> septum.<img alt=\"OP295\" data-author=\"\" data-hash=\"6911\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/Fm1m6hRKK4fIBMCBM2Hy1743669329.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Sinusitis: </strong>Ethmoid <span class=\"customMeta\" data-dictid=\"3207c2541a1692777198f4af88308b\">sinusitis</span> (most common) carries a high risk of causing <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis. <strong>(Option A)</strong></li>\n<li>Underlying <span class=\"customMeta\" data-dictid=\"02cf7655661692777185e2bf5c3254\">dental</span> problem.</li>\n<li>Dacryocystitis (inflammation of the <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> sac).</li>\n<li>Endogenous cause: Septicemia</li>\n<li>Exogenous cause: Fracture or surgery of the orbit.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Causative Organisms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong><em>Staphylococcus aureus</em></strong> <strong>(most common)</strong></li>\n<li><strong><em>Haemophilus influenzae</em></strong> <strong>(most common in children)</strong></li>\n<li><em>Streptococcus pneumoniae</em></li>\n<li><em>Streptococcus pyogenes</em></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Painful, <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> <span class=\"customMeta\" data-dictid=\"4edef7912e1692777196cb0f66e35d\">Proptosis</span> (swelling and severe pain worsened by eye movement or pressure)</li>\n<li>Restriction of eye movements (due to proptosis)</li>\n<li>Decreased visual acuity</li>\n<li>Lid <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> conjunctival <span class=\"customMeta\" data-dictid=\"2dd9736fdf16927771849f5a925f7d\">congestion</span> / chemosis</li>\n<li>Systemic symptoms: like fever, headache, nausea</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Disc edema</li>\n<li>RAPD (Relative Afferent Pupillary Defect) due to <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve dysfunction</li>\n<li>Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</li>\n<li>CRAO (Central Retinal Artery Occlusion) or CRVO (Central Retinal Venous Occlusion)</li>\n<li>Generalized <span class=\"customMeta\" data-dictid=\"afd363657e16927771982285d861d6\">septicemia</span> or pyemia.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<p><strong>References:</strong></p>\n<ul><li>↳ Reference:</li><li>↳ Parson’s Diseases of the eye, 23rd edition, Page 137. Kanski’s Clinical ophthalmology, 9th edition Page 125.</li><li>↳ Parson’s Diseases of the eye, 23rd edition, Page 137.</li><li>↳ Kanski’s Clinical ophthalmology, 9th edition Page 125.</li></u\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5OAyv91VJyBpkM60JMWz1747984727.mp3", "video": ""}, {"text": "A 25-year-old male presents with intermittent bulging of his right eye, worsening with cough and bending forward. His vision is intact, and there is no history of trauma or infection. What is the most likely cause of his condition?", "options": [{"label": "A", "text": "Cavernous sinus thrombosis", "correct": false}, {"label": "B", "text": "Orbital varix", "correct": true}, {"label": "C", "text": "Thyroid orbitopathy", "correct": false}, {"label": "D", "text": "Orbital cellulitis", "correct": false}], "correct_answer": "B. Orbital varix", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Orbital Varices</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dilated <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> channels in the orbit (part of the spectrum of developmental <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> anomalies)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most cases are <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> and the most frequent site is upper nasal.</p>\n<p>Slowly progressive <strong>intermittent proptosis</strong> which worsens with head position changes, bending forward, or Valsalva maneuver.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May involve one large vessel or multiple ectatic veins with fibrotic walls.</p>\n<p>Thrombosed lumens can contain phleboliths from calcified thrombi.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT</strong> - serpiginous, dense structures that enlarge with Valsalva, <strong>enhances with contrast</strong> administration.</p>\n<p><strong>MRI</strong> - T1 images show low <span class=\"customMeta\" data-dictid=\"ad45f1e11716927771901f3d9b18eb\">isointense</span> signal, T2 shows dark signal <span class=\"customMeta\" data-dictid=\"3ea4fc34801692777202b98af71861\">void</span> from flowing blood. Enhancement with Gadolinium is marked, except in areas of thrombosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No treatment</strong> needed for mild symptoms;</p>\n<p><strong>Surgical or embolization</strong> options for severe cases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Prognosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Good</strong> unless large lesions <span class=\"customMeta\" data-dictid=\"c6486470671692777184e25019e1f0\">compress</span> the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve, risking vision loss.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/NInyM1UR7YY8i4OB0lQt1747984258.mp3", "video": ""}, {"text": "A 48-year-old man presents with a complaint of eye protrusion. He describes experiencing a rhythmic, pulsatile sensation in his right eye for the past few weeks. Which of the following is NOT a likely cause ?", "options": [{"label": "A", "text": "Carotico-cavernous fistula", "correct": false}, {"label": "B", "text": "Saccular aneurysm of the ophthalmic artery", "correct": false}, {"label": "C", "text": "Congenital meningocele", "correct": false}, {"label": "D", "text": "Orbital cellulitis", "correct": true}], "correct_answer": "D. Orbital cellulitis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/sN3ABw5zJA9TmuuwakNC1747983847.mp3", "video": ""}, {"text": "If a patient with thyroid eye disease exhibits stable symptoms with no acute inflammation and has experienced a gradual improvement in symptoms over the past 1-2 years, which stage of Rundle’s Curve is most likely being described?", "options": [{"label": "A", "text": "Initial Phase", "correct": false}, {"label": "B", "text": "Peak Phase", "correct": false}, {"label": "C", "text": "Improvement Phase", "correct": false}, {"label": "D", "text": "Chronic Phase", "correct": true}], "correct_answer": "D. Chronic Phase", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/WXAS25lFnV0biBmLeB0l1748198896.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phase</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial Phase </strong><strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A few months.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Progressive worsening of symptoms.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peak Phase </strong><strong>(Option B ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The disease reaches its maximum severity.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Improvement Phase </strong><strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Duration</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1-2 years.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Symptoms start to improve spontaneously, transitioning from <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> to chronic.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic or “Burnt-Out” Stage </strong><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Characteristics</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Disease stabilizes; further changes are unlikely.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Focus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Typically requires <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> intervention.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Active Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Acute inflammation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Timing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Early phase of Rundle’s curve.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Potentially responsive to medical treatments.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inactive Disease</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stabilized disease with no <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> inflammation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Requires <span class=\"customMeta\" data-dictid=\"81d12f9cb01692777199e44ff3f3c1\">surgical</span> options for altering outcomes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Significance of Rundle’s Curve</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Defines the natural <span class=\"customMeta\" data-dictid=\"3c305b384216927771969ca4166493\">progression</span> of <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> eye disease and guides treatment choices based on disease phase and severity.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/43NeEH48gc2Te8BzpfWI1747983587.mp3", "video": ""}, {"text": "A 52-year-old woman with a history of thyroid disease presents with difficulty closing her eyes, noticeable eye protrusion and prominent bilateral lid retraction giving a staring and frightened appearance of the eyes as shown in the image below. Which of the following best describes the sign observed in this patient?", "options": [{"label": "A", "text": "Von Graefe's Sign", "correct": false}, {"label": "B", "text": "Kocher’s sign", "correct": true}, {"label": "C", "text": "Stellwag's Sign", "correct": false}, {"label": "D", "text": "Joffroy's Sign", "correct": false}], "correct_answer": "B. Kocher’s sign", "question_images": ["https://image.prepladder.com/notes/UVbaZEVQOrimBb3ANsYH1743667206.png"], "explanation_images": ["https://image.prepladder.com/notes/UVbaZEVQOrimBb3ANsYH1743667206.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Lid Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Dalrymple's Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Upper lid <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> causing a staring appearance (90% of cases).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Von Graefe's Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lid <span class=\"customMeta\" data-dictid=\"6ef2a80e2116927771915098fa1789\">lag</span> when the globe moves downward (50% of cases). <strong>(Option A ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Enroth's Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Puffy, oedematous <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of the eyelids.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Gifford's Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Difficulty in <span class=\"customMeta\" data-dictid=\"30ddb5b09916927771877ac72c09b7\">eversion</span> of the upper lid.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Stellwag's Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Infrequent blinking. <strong>(Option C ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Joffroy's Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Poor forehead wrinkling on looking up. <strong>(Option D ruled out)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Kocher’s sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased lid <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> with visual <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> (staring look)</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Conjunctival Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Deep Injection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pronounced redness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Chemosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Swelling of the conjunctiva.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Pupillary Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less significant; may show unequal <span class=\"customMeta\" data-dictid=\"29a08d8f9216927771869ed797367e\">dilatation</span> of pupils.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Ocular <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">Motility</span> Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Mobius's Sign</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Convergence weakness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Restrictive Myopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limited movement in the direction opposite to the affected muscle.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Exophthalmos</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Both eyes are often affected with possible <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> proptosis.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5LSzLlgfrxApHxHAAHuA1747208130.mp3", "video": ""}, {"text": "A 45-year-old woman with a history of thyroid disease presents with bilateral eye bulging and difficulty closing her eyes. On examination, there is noticeable eye protrusion, eyelid swelling, and restricted extraocular movements. Which of the following best describes the pathogenesis of her eye condition?", "options": [{"label": "A", "text": "Extraocular muscles are the primary target of inflammation.", "correct": false}, {"label": "B", "text": "The earliest defective ocular movement seen in this patient is depression.", "correct": false}, {"label": "C", "text": "T-cells attack the orbital fibroblasts and adipocytes in the orbit.", "correct": true}, {"label": "D", "text": "Inflammation is primarily due to neutrophils.", "correct": false}], "correct_answer": "C. T-cells attack the orbital fibroblasts and adipocytes in the orbit.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MsggXjVbs3BJoNje8MdP1747930704.mp3", "video": ""}, {"text": "Which of the following is not a cause of pseudoproptosis?", "options": [{"label": "A", "text": "High Myopia", "correct": false}, {"label": "B", "text": "Eyelid Retraction", "correct": false}, {"label": "C", "text": "Contralateral Enophthalmos", "correct": false}, {"label": "D", "text": "Orbital Cellulitis", "correct": true}], "correct_answer": "D. Orbital Cellulitis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Prh2Y9GfI4PvU7bwJSD01747930247.mp3", "video": ""}, {"text": "A 34-year-old woman with a history of hyperthyroidism presents with bilateral proptosis and difficulty closing her eyes. To assess the degree of eye protrusion, a Hertel's exophthalmometer is used. Which of the following statements regarding the use of the exophthalmometer is correct?", "options": [{"label": "A", "text": "Normal values for exophthalmometer readings are typically between 20 and 30 mm.", "correct": false}, {"label": "B", "text": "Difference of 2–3 mm or more between the two eyes is suspicious regardless of the absolute values", "correct": true}, {"label": "C", "text": "A reading greater than 10 mm in both eyes is indicative of proptosis.", "correct": false}, {"label": "D", "text": "Hertel's exophthalmometer can only be used to measure the degree of proptosis in one eye at a time.", "correct": false}], "correct_answer": "B. Difference of 2–3 mm or more between the two eyes is suspicious regardless of the absolute values", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/CG1Fc6Vi8IFDAe6EnjSl1743667142.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/oEjoPaxGAK42FX6P68wU1747930023.mp3", "video": ""}, {"text": "Which condition is most commonly associated with bilateral proptosis in adults?", "options": [{"label": "A", "text": "Orbital cellulitis", "correct": false}, {"label": "B", "text": "Thyroid ophthalmopathy", "correct": true}, {"label": "C", "text": "Rhabdomyosarcoma", "correct": false}, {"label": "D", "text": "Neuroblastoma", "correct": false}], "correct_answer": "B. Thyroid ophthalmopathy", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unilateral proptosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bilateral proptosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Orbital cellulitis</li>\n<li>Developmental anomalies</li>\n<li>Inflammatory conditions</li>\n<li>Vascular anomalies</li>\n<li>Neoplasms</li>\n<li>Metabolic diseases</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Thyroid eye disease (thyroid ophthalmopathy)</li>\n<li>Orbital myositis</li>\n<li>Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</li>\n<li>Metastatic neuroblastoma</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Axial Proptosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nonaxial or Abaxial Proptosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lesion will originate in the intraconal space, e.g., <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve gliomas, meningiomas and <span class=\"customMeta\" data-dictid=\"34f284128d1692777183e1cf6e17d7\">cavernous</span> haemangiomas.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The eye is displaced from its central location, opposite to the site of the spaceoccupying lesion, e.g., superotemporally located dermoids and <span class=\"customMeta\" data-dictid=\"7a742b06701692777191bdca4f04a0\">lacrimal</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> tumours.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>In Adults</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>In Children</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Cavernous haemangiomas</li>\n<li>Mucocoeles</li>\n<li>Lacrimal <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> tumours</li>\n<li>Lymphoid tumours</li>\n<li>Meningiomas</li>\n<li>Metastases from the breast, lung and <span class=\"customMeta\" data-dictid=\"b3a647ce2516927771881427f56c1d\">gastrointestinal</span> <span class=\"customMeta\" data-dictid=\"1a1307223f16927772017a994bfc39\">tract</span> cancers.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Capillary haemangiomas</li>\n<li>Venolymphatic malformations</li>\n<li>Optic nerve glioma</li>\n<li>Rhabdomyosarcoma <strong>(Option C ruled out)</strong></li>\n<li>Leukaemias</li>\n<li>Metastatic neuroblastoma</li>\n<li>Plexiform neurofibromatosis</li>\n<li>Congenital causes, e.g. <span class=\"customMeta\" data-dictid=\"ee123cf86916927772004fc7b0a157\">teratoma</span> and <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> lesions.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rorKOnNjc7B8OEwvPJvA1747929561.mp3", "video": ""}, {"text": "Which surgical space is typically used for administering a retrobulbar injection?", "options": [{"label": "A", "text": "Sub-Tenon Surgical Space", "correct": false}, {"label": "B", "text": "Extraconal Surgical Space", "correct": false}, {"label": "C", "text": "Intraconal Surgical Space", "correct": true}, {"label": "D", "text": "Subarachnoid Surgical Space", "correct": false}], "correct_answer": "C. Intraconal Surgical Space", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/99ruiWMey8tXqnIJ4Lve1747929433.mp3", "video": ""}, {"text": "Which of the following statements is TRUE regarding the orbital foramina and fissures?", "options": [{"label": "A", "text": "Superior orbital fissure is between the medial and lateral walls.", "correct": false}, {"label": "B", "text": "Inferior orbital fissure is between the lesser wing of the sphenoid and the maxillary bone.", "correct": false}, {"label": "C", "text": "Optic foramen is between the lateral wall and the orbital floor.", "correct": false}, {"label": "D", "text": "Optic nerve and ophthalmic artery pass through the optic foramen.", "correct": true}], "correct_answer": "D. Optic nerve and ophthalmic artery pass through the optic foramen.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/oaPRuken1CPVdfRGlkoE1743667027.png", "https://image.prepladder.com/notes/HbdWML2OALAbCy3jvzjY1743667051.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/EPpVOOG0vaERaJGWMoco1747929176.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 35 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient presents with proptosis that increases when bending down. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Orbital Varices", "correct": true}, {"label": "B", "text": "Thyroid Eye Disease", "correct": false}, {"label": "C", "text": "Cavernous Sinus Thrombosis", "correct": false}, {"label": "D", "text": "Orbital Cellulitis", "correct": false}], "correct_answer": "A. Orbital Varices", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Orbital Varices</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dilated <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> channels in the orbit (part of the spectrum of developmental <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> anomalies)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most cases are <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> and the most frequent site is upper nasal.</p>\n<p>Slowly progressive <strong>intermittent proptosis</strong> which worsens with head position changes, bending forward, or Valsalva maneuver.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>May involve one large vessel or multiple ectatic veins with fibrotic walls.</p>\n<p>Thrombosed lumens can contain phleboliths from calcified thrombi.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>CT</strong> - serpiginous, dense structures that enlarge with Valsalva, <strong>enhances with contrast</strong> administration.</p>\n<p><strong>MRI</strong> - T1 images show low <span class=\"customMeta\" data-dictid=\"ad45f1e11716927771901f3d9b18eb\">isointense</span> signal, T2 shows dark signal <span class=\"customMeta\" data-dictid=\"3ea4fc34801692777202b98af71861\">void</span> from flowing blood. <span class=\"customMeta\" data-dictid=\"4749be0e3f1692777187a4b4100c1d\">Enhancement</span> with <span class=\"customMeta\" data-dictid=\"e3767003061692777187b931c6a08f\">Gadolinium</span> is marked, except in areas of thrombosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No treatment</strong> needed for mild symptoms;</p>\n<p><strong>Surgical or embolization</strong> options for severe cases.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prognosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Good</strong> unless large lesions <span class=\"customMeta\" data-dictid=\"c6486470671692777184e25019e1f0\">compress</span> the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve, risking vision loss.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is false regarding the condition shown in the image?", "options": [{"label": "A", "text": "NOSPEC classification is used", "correct": false}, {"label": "B", "text": "Management corresponds to an improvement in the thyrotoxic state", "correct": true}, {"label": "C", "text": "Vision loss may occur", "correct": false}, {"label": "D", "text": "It is not seen in 10% of patients with hyperthyroidism", "correct": false}], "correct_answer": "B. Management corresponds to an improvement in the thyrotoxic state", "question_images": ["https://image.prepladder.com/content/03gzCNvcZlpUXDpSFMZw1724830659.png"], "explanation_images": [], "explanation": "<p>Correct Option B - Management corresponds to an improvement in the &lt;span class=\"customMeta\" data-dictid=\"d1ad396c00169277720080f8a84f23\"&gt;thyrotoxic&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most common cause of proptosis in a middle-aged person?", "options": [{"label": "A", "text": "Orbital varix", "correct": false}, {"label": "B", "text": "Thyroid eye disease", "correct": true}, {"label": "C", "text": "Retinoblastoma", "correct": false}, {"label": "D", "text": "Cavernous hemangioma", "correct": false}], "correct_answer": "B. Thyroid eye disease", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\"&gt;Thyroid&lt;/span&g\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Unilateral proptosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Bilateral proptosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>\n<p>Dermoid cyst</p>\n</li>\n<li>\n<p>Orbital teratoma</p>\n</li>\n<li>\n<p>Intraorbital foreign body</p>\n</li>\n<li>\n<p>Orbital cellulitis</p>\n</li>\n<li>\n<p>Cavernous <span class=\"customMeta\" data-dictid=\"b0046463171692777198e0beea83e7\">sinus</span> thrombosis</p>\n</li>\n<li>\n<p>Panophthalmitis</p>\n</li>\n<li>\n<p>Thyroid ophthalmoplegia</p>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>\n<p>Craniofacial dysostosis</p>\n</li>\n<li>\n<p>Osteitis deformans</p>\n</li>\n<li>\n<p>Mikulicz’s syndrome</p>\n</li>\n<li>\n<p>Ewing’s sarcoma</p>\n</li>\n<li>\n<p>Neuroblastoma</p>\n</li>\n<li>\n<p>Systemic amyloidosis</p>\n</li>\n<li>\n<p>Wegener’s granulomatosis</p>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most common cause of proptosis in a middle-aged person?", "options": [{"label": "A", "text": "Orbital varix B) Thyroid eye disease C) Retinoblastoma D) Cavernous hemangioma", "correct": false}, {"label": "B", "text": "Thyroid eye disease", "correct": true}, {"label": "C", "text": "Retinoblastoma", "correct": false}, {"label": "D", "text": "Cavernous hemangioma", "correct": false}], "correct_answer": "B. Thyroid eye disease", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/aejHuPHtJGPiQ8QUYF511741277097.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lid Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dalrymple's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Upper lid <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> causing a staring appearance (90% of cases).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Von Graefe's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lid <span class=\"customMeta\" data-dictid=\"6ef2a80e2116927771915098fa1789\">lag</span> when the globe moves downward (50% of cases).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enroth's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Puffy, oedematous <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of the eyelids.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gifford's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Difficulty in <span class=\"customMeta\" data-dictid=\"30ddb5b09916927771877ac72c09b7\">eversion</span> of the upper lid.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Stellwag's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Infrequent blinking.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Joffroy's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Poor forehead wrinkling on looking up.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Kocher’s sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increased lid <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> with visual <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> (staring look)</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjunctival Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Deep Injection</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pronounced redness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chemosis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Swelling of the conjunctiva.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pupillary Signs</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Less significant; may show unequal <span class=\"customMeta\" data-dictid=\"29a08d8f9216927771869ed797367e\">dilatation</span> of pupils.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ocular <span class=\"customMeta\" data-dictid=\"c8c1db40c9169277719258df1a6b43\">Motility</span> Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mobius's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Convergence weakness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Restrictive Myopathy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limited movement in the direction opposite to the affected muscle.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Exophthalmos</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Both eyes are often affected with possible <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> proptosis.</strong><strong>(Option B)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Following instrument is used to measure?", "options": [{"label": "A", "text": "Proptosis", "correct": true}, {"label": "B", "text": "Squint", "correct": false}, {"label": "C", "text": "Ptosis", "correct": false}, {"label": "D", "text": "Diplopia", "correct": false}], "correct_answer": "A. Proptosis", "question_images": ["https://image.prepladder.com/content/kRb3dgYdIb9td7Tq59gf1745929692.png"], "explanation_images": ["https://image.prepladder.com/content/qORxclt3lfFHPwaWIajn1745929699.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A middle-aged woman presented with bilateral proptosis, restriction of eye movements, and chemosis. Her thyroid profile showed she was hyperthyroid. What is the most probable cause?", "options": [{"label": "A", "text": "Orbital pseudotumor", "correct": false}, {"label": "B", "text": "Grave’s ophthalmopathy", "correct": true}, {"label": "C", "text": "Orbital lymphoma", "correct": false}, {"label": "D", "text": "Orbital cellulitis", "correct": false}], "correct_answer": "B. Grave’s ophthalmopathy", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/r9tnTWfktKD0PX1ZEPWL1746516996.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lid Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Dalrymple's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Upper lid <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> causing a staring appearance (90% of cases).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Von Graefe's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lid <span class=\"customMeta\" data-dictid=\"6ef2a80e2116927771915098fa1789\">lag</span> when the globe moves downward (50% of cases).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Enroth's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Puffy, oedematous <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> of the eyelids.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Gifford's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Difficulty in <span class=\"customMeta\" data-dictid=\"30ddb5b09916927771877ac72c09b7\">eversion</span> of the upper lid.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Stellwag's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Infrequent blinking.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Joffroy's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Poor forehead wrinkling on looking up.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Kocher’s sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Increased lid <span class=\"customMeta\" data-dictid=\"b7eab06f1a1692777197e0b50983e5\">retraction</span> with visual <span class=\"customMeta\" data-dictid=\"71fd4297541692777202797b7596b9\">fixation</span> (staring look)</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Deep Injection</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pronounced redness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Chemosis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Swelling of the conjunctiva.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pupillary Signs</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Less significant; may show unequal <span class=\"customMeta\" data-dictid=\"29a08d8f9216927771869ed797367e\">dilatation</span> of pupils.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ocular Motility Defects</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Mobius's Sign</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Convergence weakness.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Restrictive Myopathy</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Limited movement in the direction opposite to the affected muscle.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Exophthalmos</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Both eyes are often affected with possible <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> proptosis.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 5-year-old was brought with the complaints of protrusion of the right eye with no h/o fever. CT scan showed a well – defined mass in the orbit with an irregular border and adjacent bony destruction. Biopsy showed small, round cells which were positive for Desmin in immunohistochemistry. What is the probable diagnosis ?", "options": [{"label": "A", "text": "Retinoblastoma", "correct": false}, {"label": "B", "text": "Cavernous hemangioma", "correct": false}, {"label": "C", "text": "Orbital Cellulitis", "correct": false}, {"label": "D", "text": "Rhabdomyosarcoma", "correct": true}], "correct_answer": "D. Rhabdomyosarcoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Rh\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Blow out fracture can be due to?", "options": [{"label": "A", "text": "Tennis ball injury", "correct": true}, {"label": "B", "text": "Chisel and hammer injury", "correct": false}, {"label": "C", "text": "Sudden fall", "correct": false}, {"label": "D", "text": "Penetrating injury by knife", "correct": false}], "correct_answer": "A. Tennis ball injury", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Tennis ball inju\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is true regarding a patient who has a history of falling on a symmetrical surface and presents with enophthalmos, diplopia on upward gaze, and loss of sensitivity over the cheek?", "options": [{"label": "A", "text": "Maxillary fracture", "correct": false}, {"label": "B", "text": "It is a blow out fracture", "correct": true}, {"label": "C", "text": "Zygomatic bone is most likely injured", "correct": false}, {"label": "D", "text": "Frontal bone fracture", "correct": false}], "correct_answer": "B. It is a blow out fracture", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - It is a blow out fractu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most common site of an orbital blowout fracture?", "options": [{"label": "A", "text": "Medial wall", "correct": false}, {"label": "B", "text": "Lateral wall", "correct": false}, {"label": "C", "text": "Roof", "correct": false}, {"label": "D", "text": "Floor", "correct": true}], "correct_answer": "D. Floor", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - F\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 56-year-old male presented with concerns about his eyes bulging and becoming more prominent over the past month. He has previously been diagnosed with Grave's disease. The image below shows the patient's eyes. Based on these findings, what is the most probable diagnosis?", "options": [{"label": "A", "text": "Orbital cellulitis", "correct": false}, {"label": "B", "text": "Preseptal cellulitis", "correct": false}, {"label": "C", "text": "Thyroid eye disease", "correct": true}, {"label": "D", "text": "Capillary hemangioma", "correct": false}], "correct_answer": "C. Thyroid eye disease", "question_images": ["https://image.prepladder.com/content/yvtG9vkBc8pAENDiqIpN1715259659.png"], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\"&gt;Thyroid&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What would be your diagnosis for a patient who has a previous trauma history and is currently experiencing diplopia and following findings on CT?", "options": [{"label": "A", "text": "Le-fort fracture", "correct": false}, {"label": "B", "text": "Fracture maxilla", "correct": false}, {"label": "C", "text": "Fracture zygomatic", "correct": false}, {"label": "D", "text": "Blow out fracture", "correct": true}], "correct_answer": "D. Blow out fracture", "question_images": ["https://image.prepladder.com/content/UaB1ZQr7YF10j8j9NCOO1715758628.png"], "explanation_images": [], "explanation": "<p>Correct Option D - Blowout Fractu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the first sign to be seen in a patient with sympathetic ophthalmitis?", "options": [{"label": "A", "text": "Circumcorneal congestion", "correct": false}, {"label": "B", "text": "Hypopyon", "correct": false}, {"label": "C", "text": "Retrolental flare", "correct": true}, {"label": "D", "text": "Iris nodule", "correct": false}], "correct_answer": "C. Retrolental flare", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"190a7ebe7916927771979100bb9a9d\"&gt;Retrolental&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "During evisceration of the right eyeball, which layer of the eyeball is eliminated?", "options": [{"label": "A", "text": "Middle and inner", "correct": true}, {"label": "B", "text": "Outer and middle", "correct": false}, {"label": "C", "text": "Outer and inner", "correct": false}, {"label": "D", "text": "All the layers of eyeball", "correct": false}], "correct_answer": "A. Middle and inner", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - M\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Diagnose the clinical condition as shown in photo:", "options": [{"label": "A", "text": "Keratoglobus", "correct": false}, {"label": "B", "text": "Keratoconus", "correct": false}, {"label": "C", "text": "Limbal dermoid", "correct": true}, {"label": "D", "text": "Pinguecula", "correct": false}], "correct_answer": "C. Limbal dermoid", "question_images": ["https://image.prepladder.com/content/LkBqpd4H6Hw12ABAyzej1691374390.png"], "explanation_images": ["https://image.prepladder.com/content/cT279F4RRrNhuhTIw11V1695203850.png"], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\"&gt;Limbal&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most common primary intraocular malignancy in adults?", "options": [{"label": "A", "text": "Retinoblastoma", "correct": false}, {"label": "B", "text": "Malignant Choroidal melanoma", "correct": true}, {"label": "C", "text": "Reticulum cell sarcoma", "correct": false}, {"label": "D", "text": "Neurofibroma", "correct": false}], "correct_answer": "B. Malignant Choroidal melanoma", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\"&gt;Malignant&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\"&gt;Choroidal&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 35-year-old female reports recurring episodes of discomfort, pain, and a sensation of pressure behind her left eye. She exhibits intermittent reducible proptosis, and her symptoms intensify when she bends forward. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Orbital hemangioma", "correct": false}, {"label": "B", "text": "Orbital varices", "correct": true}, {"label": "C", "text": "Orbital metastasis", "correct": false}, {"label": "D", "text": "Orbital dermoid cyst", "correct": false}], "correct_answer": "B. Orbital varices", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\"&gt;Orbital&lt;/span&gt; v\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 27 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "Which of the following is a characteristic finding in the fundus examination of a patient with Stargardt disease?", "options": [{"label": "A", "text": "Beaten bronze appearance", "correct": true}, {"label": "B", "text": "Cotton wool spots and Hard exudates", "correct": false}, {"label": "C", "text": "Dark/silent choroid", "correct": false}, {"label": "D", "text": "Honeycomb appearance", "correct": false}], "correct_answer": "A. Beaten bronze appearance", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/apzeus5tKr0TGLiYOUkT1742978586.png", "https://image.prepladder.com/notes/YShl6CDSqyskX3OvQiW21742978694.png", "https://image.prepladder.com/notes/qsfmrde1oCNreiuiVoNU1742978874.png"], "explanation": "<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HCOil4ngP6LmhOVJy0JB1746682693.mp3", "video": ""}, {"text": "A 14-month-old child is diagnosed with retinoblastoma in the right eye. The tumor is confined to the retina, located posterior to equator, measures 2.5 mm in greatest dimension, and is located 3.5 mm from the fovea. There is no vitreous or subretinal seeding. According to the International Classification of Retinoblastoma (ICRB), how would this tumor be classified, and what will be the appropriate treatment?", "options": [{"label": "A", "text": "Group A; Systemic chemotherapy with focal consolidation", "correct": false}, {"label": "B", "text": "Group B; Plaque radiotherapy", "correct": false}, {"label": "C", "text": "Group B; Enucleation", "correct": false}, {"label": "D", "text": "Group A; Laser photocoagulation", "correct": true}], "correct_answer": "D. Group A; Laser photocoagulation", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Small <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> tumors (&lt;3 mm), away from foveola/optic disc, no seeding</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Focal therapy (laser photocoagulation, cryotherapy)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All remaining <span class=\"customMeta\" data-dictid=\"635650799116927771862d7cb568f4\">discrete</span> tumors confined to retina, any size or location; no seeding</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Systemic <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> ± <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> therapy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group C</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Local subretinal/vitreous seeding, discrete</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chemotherapy ± focal</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group D</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Diffuse seeding</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Chemoreduction ± external beam radiation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Group E</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extensive tumor, <span class=\"customMeta\" data-dictid=\"624c00049d1692777193b1a9d81379\">neovascular</span> glaucoma, <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> media, invasion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enucleation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fRq03DcRq0Gj7UYl3KDg1746456745.mp3", "video": ""}, {"text": "A 2-year-old child is brought to the ophthalmology clinic with a white pupillary reflex in the right eye, noticed by the parents in flash photography. On examination, the child has strabismus. Which of the following is NOT a condition to be considered in the differential diagnosis of this presentation?", "options": [{"label": "A", "text": "Coats' disease", "correct": false}, {"label": "B", "text": "Persistent hyperplastic primary vitreous", "correct": false}, {"label": "C", "text": "Retinopathy of prematurity", "correct": false}, {"label": "D", "text": "Optic nerve glioma", "correct": true}], "correct_answer": "D. Optic nerve glioma", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Leukocoria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Congenital cataract</li>\n<li>Inflammatory deposits in <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> following a plastic <span class=\"customMeta\" data-dictid=\"fd270d89c016927771857f2dcac3fd\">cyclitis</span> or choroiditis,</li>\n<li>Coloboma of the choroid,</li>\n<li>Retinopathy of prematurity<strong> (Option C)</strong></li>\n<li>Persistent hyperplastic <span class=\"customMeta\" data-dictid=\"49f71c1713169277719610beb55959\">primary vitreous</span> <strong>(Option B)</strong></li>\n<li>Toxocara endophthalmitis</li>\n<li>Exudative <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> of Coats <strong>(Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Endophytic retinoblastoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Tuberous sclerosis</li>\n<li>Neurofibromatosis</li>\n<li>Astrocytoma</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exophytic Retinoblastoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Exudative <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> of Coats</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4zY2yydoOgXMtu00ZMnB1746685521.mp3", "video": ""}, {"text": "A 2-year-old child presents with leukocoria in the right eye. Fundus examination reveals a white, elevated mass in the retina. Histopathological examination of the tumor shows rosettes with central lumen. Which of the following is the most specific histological feature for this condition?", "options": [{"label": "A", "text": "Homer-Wright rosettes", "correct": false}, {"label": "B", "text": "Flexner-Wintersteiner rosettes", "correct": true}, {"label": "C", "text": "Pseudorosettes", "correct": false}, {"label": "D", "text": "Undifferentiated tumor cells", "correct": false}], "correct_answer": "B. Flexner-Wintersteiner rosettes", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/GsyrpRFCSUutov18dZWy1742981317.png", "https://image.prepladder.com/notes/WgZgn06nRhxM6NMXZJcv1742981317.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Flexner-Wintersteiner rosettes </strong><strong>(highly specific)-</strong><strong> </strong>These are composed of an ‘empty’ <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> surrounded by columnar cells</li>\n<li><strong>Homer-Wright rosettes</strong> - These are pseudo-rosettes and consist of cells surrounding a central <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> made up of their processes</li>\n<li>Undifferentiated tumor cells</li>\n<li>Areas of <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and calcification</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Leukocoria (60%)</li>\n<li>Strabismus (20%)</li>\n<li>Painful red eye (7%)</li>\n<li>Poor vision (5%)</li>\n<li>Asymptomatic (3%)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Fundus Examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>White, elevated mass in the retina</li>\n<li>Can be endophytic, exophytic, or mixed growth</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>CT scan:</strong> <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">Calcification</span> in 90% of cases</li>\n<li><strong>MRI:</strong> Better for evaluating <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve and <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> extension</li>\n<li><strong>Ultrasound:</strong> Useful for initial screening</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Genetic Testing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>RB1 gene <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> on <span class=\"customMeta\" data-dictid=\"7157c1f59916927771846116d74646\">chromosome</span> 13q14</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/K8KfFUUyTcMRDvoMg0551746685872.mp3", "video": ""}, {"text": "A 2-year-old child presents with the following findings as shown in the image. Genetic testing reveals a mutation in the RB1 gene. Which of the following statements best describes the genetic findings associated with this condition?", "options": [{"label": "A", "text": "Retinoblastoma can be inherited in an autosomal dominant manner, with affected individuals having a 100% chance of passing on the mutation.", "correct": false}, {"label": "B", "text": "Retinoblastoma typically arises from a germline mutation in the RB1 gene, followed by a second somatic mutation.", "correct": true}, {"label": "C", "text": "Affected children with retinoblastoma often have mutations in both the RB1 and TP53 genes.", "correct": false}, {"label": "D", "text": "A single mutation in the RB1 gene is usually sufficient for the development of retinoblastoma in both familial and sporadic cases.", "correct": false}], "correct_answer": "B. Retinoblastoma typically arises from a germline mutation in the RB1 gene, followed by a second somatic mutation.", "question_images": ["https://image.prepladder.com/notes/9KW2suwg8PW1dTNZTKFj1742981140.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/nv8dCAuaswZzWWQOnYyQ1746687363.mp3", "video": ""}, {"text": "A 55-year-old woman with a history of proliferative diabetic retinopathy presents with sudden vision changes in her right eye. She reports seeing floaters and flashes of light. On fundoscopy, there is evidence of fibrous tissue contraction and retinal elevation, but no retinal breaks are seen. What is the most appropriate treatment approach for this patient?", "options": [{"label": "A", "text": "Laser photocoagulation", "correct": false}, {"label": "B", "text": "Cryotherapy with scleral buckling", "correct": false}, {"label": "C", "text": "Pars plana vitrectomy", "correct": true}, {"label": "D", "text": "Pneumatic retinopexy", "correct": false}], "correct_answer": "C. Pars plana vitrectomy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/kAqo4gX9TJVo9w2Dzhjq1742980669.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xG3wDFr0d9hppwts13r61746685288.mp3", "video": ""}, {"text": "A 60-year-old man presents with a sudden onset of flashes of light and a shadow resembling a curtain in the peripheral vision of his right eye. He denies any recent trauma. On examination, fundus evaluation reveals a retinal detachment with a retinal break in the upper temporal quadrant. What is the most appropriate next step in the management of this patient?", "options": [{"label": "A", "text": "Intravitreal anti-VEGF injection", "correct": false}, {"label": "B", "text": "Pneumatic retinopexy with gas injection", "correct": true}, {"label": "C", "text": "Pars plana vitrectomy with silicone oil tamponade", "correct": false}, {"label": "D", "text": "Drainage of subretinal fluid with diathermy to seal the break", "correct": false}], "correct_answer": "B. Pneumatic retinopexy with gas injection", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/qtq1jDnFeaECIWetieYg1742980591.png", "https://image.prepladder.com/notes/GOFCaIXFPCMgj4KqdWBO1742980634.png", "https://image.prepladder.com/notes/kAqo4gX9TJVo9w2Dzhjq1742980669.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/564WZg9YAr3as8M3RFOx1746684187.mp3", "video": ""}, {"text": "A 55-year-old man reports the sudden appearance of flashes of light, followed by a dark cloud or veil in the peripheral vision of his left eye. Examination reveals a greyish reflex in the affected quadrant of the retina. What type of retinal detachment is most likely in this patient?", "options": [{"label": "A", "text": "Rhegmatogenous Retinal Detachment", "correct": true}, {"label": "B", "text": "Tractional Retinal Detachment", "correct": false}, {"label": "C", "text": "Exudative Retinal Detachment", "correct": false}, {"label": "D", "text": "Macular Hole", "correct": false}], "correct_answer": "A. Rhegmatogenous Retinal Detachment", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/Qq6I2AX6uD6wObbHvkGL1742979558.png", "https://image.prepladder.com/notes/GJm16ZKqChr8mRdPplBZ1742979646.png", "https://image.prepladder.com/notes/Fv4bWtqOhgiVEMAotFeB1742979711.png", "https://image.prepladder.com/notes/DHMt7Vb4KMZUo4G6E79d1742979797.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:616px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rhegmatogenous <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li><strong>Floaters </strong>(dark spots) due to rapid <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> degeneration.</li>\n<li><strong>Photopsia </strong>(flashes of light) caused by <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"3a74ed0fcf16927771901a79847565\">irritation</span> from <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> movements.</li>\n<li>Gradual <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> loss, initially localized, progressing to total vision loss as <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> spreads.</li>\n<li><strong>Dark veil/cloud in front of the eye</strong>, particularly when <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> reaches the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> region.</li>\n</ol>\n<p style=\"text-align: center;\"><img alt=\"-\" data-author=\"NYC Wanderer (Kevin Eng) \" data-hash=\"1828\" data-license=\"CC BY-SA 2.0\" data-source=\"https://en.wikipedia.org/wiki/Book#/media/File:Gutenberg_Bible,_Lenox_Copy,_New_York_Public_Library,_2009._Pic_01.jpg\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/Qq6I2AX6uD6wObbHvkGL1742979558.png\"/></p>\n<ol>\n<li>Sudden, painless vision loss in large, central detachment.</li>\n<li>Retinal breaks may be round, horseshoe-shaped, slit-like, or large <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> dialysis.</li>\n</ol>\n<p style=\"text-align: center;\"><img alt=\"-\" data-author=\"Jesse Vislisel, MD\" data-hash=\"1829\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://eyerounds.org/atlas/pages/rhegmatogenous-ret-detach.htm#gsc.tab=0\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/GJm16ZKqChr8mRdPplBZ1742979646.png\"/></p>\n<ol>\n<li>Vitreous pigments (tobacco dusting or <strong>Shaffer sign</strong>) are seen in the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> detachment.</li>\n<li>Old <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> shows <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> thinning, <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> <span class=\"customMeta\" data-dictid=\"6e26f8de1c1692777185d8f3885a0c\">demarcation</span> lines (high water marks), and secondary <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> cysts.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Gradual, progressive visual loss</li>\n<li>Typically painless</li>\n<li>No associated flashes or floaters</li>\n<li><strong>Vitreoretinal bands present</strong></li>\n<li>No <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> breaks</li>\n<li>Detached area - <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> and localized</li>\n<li>No shifting fluid</li>\n</ol>\n<p style=\"text-align: center;\"><img alt=\"-\" data-author=\"NA\" data-hash=\"1830\" data-license=\"NA\" data-source=\"NA\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/Fv4bWtqOhgiVEMAotFeB1742979711.png\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exudative <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ol>\n<li>Painless and sudden or gradual visual loss</li>\n<li>No photopsia, holes/ tears, folds and undulations.</li>\n<li>Smooth and <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> with <span class=\"customMeta\" data-dictid=\"45d1f54a631692777195670b446c7e\">pigmentary</span> disturbances</li>\n<li>Rounded and fixed with <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> on the tumor summit.</li>\n<li><strong>Shifting fluid </strong>- changing the position of the detached area with gravity - hallmark feature.</li>\n</ol>\n<p style=\"text-align: center;\"><img alt=\"-\" data-author='\"Henry Zou Lauren Fletcher-Morehouse\"' data-hash=\"1831\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Exudative-retinal-detachment-ERD-of-both-eyes-at-one-week-post-op_fig1_362643260\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/DHMt7Vb4KMZUo4G6E79d1742979797.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/F3Gvh8ooxe2s3hfKgrhy1746683802.mp3", "video": ""}, {"text": "A 10-year-old child presents with a mild reduction in vision in both eyes. Fundus examination reveals a \"sunny-side up egg\" appearance in the macular region with yellowish subretinal material. The child’s father has a similar history of visual impairment since childhood. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Stargardt Disease", "correct": false}, {"label": "B", "text": "Best Vitelliform Macular Dystrophy", "correct": true}, {"label": "C", "text": "Retinitis Pigmentosa", "correct": false}, {"label": "D", "text": "Leber Congenital Amaurosis", "correct": false}], "correct_answer": "B. Best Vitelliform Macular Dystrophy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/gVt9fw1X4ftbcvHVOAke1742979201.png", "https://image.prepladder.com/notes/FGCb1avmSfxoHPXq8QNS1742979319.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/9DbbsjFNjAFcTFtzyCOp1746683516.mp3", "video": ""}, {"text": "A 16-year-old patient presents with progressive vision loss. On examination, the ophthalmologist notes a central scotoma and yellowish-white flecks in the macular region of the retina. A diagnosis of Stargardt disease is made. All of the following are true statements about Stargardt disease, except:", "options": [{"label": "A", "text": "It is also known as juvenile macular dystrophy", "correct": false}, {"label": "B", "text": "Fundus examination showing flame-shaped hemorrhages", "correct": true}, {"label": "C", "text": "Vitamin A supplementation should be avoided", "correct": false}, {"label": "D", "text": "Fundus autofluorescence", "correct": false}], "correct_answer": "B. Fundus examination showing flame-shaped hemorrhages", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tF2qs1gjMIMtkujxUP3t1746682944.mp3", "video": ""}, {"text": "A 35-year-old male presents with sudden distrubunce of vision in his right eye for two weeks. He reports distortion of images. He has been intermittently using corticosteroids for allergies. His Visual acuity in the right eye is 6/18. FFA and OCT findings are given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Central serous chorioretinopathy", "correct": true}, {"label": "B", "text": "Age-related macular degeneration", "correct": false}, {"label": "C", "text": "Cystoid macular edema", "correct": false}, {"label": "D", "text": "Retinal vein occlusion", "correct": false}], "correct_answer": "A. Central serous chorioretinopathy", "question_images": ["https://image.prepladder.com/notes/E2VIQz6M9OMqNkC53bpU1742974346.png", "https://image.prepladder.com/notes/60Kyy7eEGrAeACMgIVAU1746690458.png"], "explanation_images": ["https://image.prepladder.com/notes/k37xjNDncAi3dIQukWkg1742974505.png", "https://image.prepladder.com/notes/R3CCwoWHd4Q9A3MaTlvA1742974937.png", "https://image.prepladder.com/notes/Cnm32wt46ugZIILThGhs1742974507.png", "https://image.prepladder.com/notes/E2VIQz6M9OMqNkC53bpU1742974346.png"], "explanation": "<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/R98QR3F3gOsBINeOhQDW1746672073.mp3", "video": ""}, {"text": "Which of the following is not related to retinitis pigmentosa?", "options": [{"label": "A", "text": "Refsum's disease", "correct": false}, {"label": "B", "text": "Laurence-Moon-Bardet-Biedl syndrome", "correct": false}, {"label": "C", "text": "Kearns-Sayer syndrome", "correct": false}, {"label": "D", "text": "Conductive deafness", "correct": true}], "correct_answer": "D. Conductive deafness", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dtTL7gDJQmcz5oYEFZmH1746682441.mp3", "video": ""}, {"text": "A 30-year-old woman presents with progressive night blindness and gradual loss of peripheral vision over the past few years. Her family history reveals that her father had similar symptoms. On examination, you observe characteristic retinal changes, including bone spicule pigmentation. To evaluate the functional status of her retina more accurately, which diagnostic test would you choose to confirm the suspicion of retinitis pigmentosa (RP)?", "options": [{"label": "A", "text": "Electroretinography (ERG)", "correct": true}, {"label": "B", "text": "Optical Coherence Tomography (OCT)", "correct": false}, {"label": "C", "text": "Visual Field Testing", "correct": false}, {"label": "D", "text": "Electrooculogram (EOG)", "correct": false}], "correct_answer": "A. Electroretinography (ERG)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/uWsYfeuOTN8TWVoADKXQ1742978339.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DILlo989p7mQmxWriH581746682162.mp3", "video": ""}, {"text": "A 32-year-old female presents with difficulty seeing in low light and peripheral vision loss that has gradually worsened over several years. On fundoscopy, the following findings are noted. Which of the following conditions is most likely responsible for these findings?", "options": [{"label": "A", "text": "Retinitis Pigmentosa", "correct": true}, {"label": "B", "text": "Chronic Central Serous Chorioretinopathy", "correct": false}, {"label": "C", "text": "Age-related Macular Degeneration", "correct": false}, {"label": "D", "text": "Toxoplasmic Retinochoroiditis", "correct": false}], "correct_answer": "A. Retinitis Pigmentosa", "question_images": ["https://image.prepladder.com/notes/cKleiu6YZTdWFJgck66K1742977965.png"], "explanation_images": ["https://image.prepladder.com/notes/BshYaAlCuuBHZyDdoBG71742978069.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QKnHeAqDgR8oaTYcWhXg1745222326.mp3", "video": ""}, {"text": "A 32-year-old woman presents with gradual central vision loss in both eyes. Fundus examination reveals concentric rings of retinal pigment epithelium (RPE) atrophy and hyperpigmentation centred on the fovea, creating a characteristic appearance. The image showing the appearance is given below: Which of the following is LEAST likely to be associated with this condition?", "options": [{"label": "A", "text": "Long-term hydroxychloroquine use", "correct": false}, {"label": "B", "text": "Cone dystrophy", "correct": false}, {"label": "C", "text": "Chloroquine maculopathy", "correct": false}, {"label": "D", "text": "Chronic central serous chorioretinopathy", "correct": true}], "correct_answer": "D. Chronic central serous chorioretinopathy", "question_images": ["https://image.prepladder.com/notes/YvqCJDQZS7lAVR48Lttc1742977856.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/23reO3gIArXJTXzuzqEb1746677937.mp3", "video": ""}, {"text": "A 68-year-old woman presents with gradual vision loss in her right eye over the past 6 months. Her ophthalmologist suspects age-related macular degeneration (AMD) and orders further tests. What is the most sensitive modality to detect exudative AMD?", "options": [{"label": "A", "text": "Optical Coherence Tomography (OCT)", "correct": true}, {"label": "B", "text": "Slit-lamp biomicroscopy using a +90 or +78 D lens", "correct": false}, {"label": "C", "text": "Indocyanine green angiography (ICGA)", "correct": false}, {"label": "D", "text": "Fluorescein angiography", "correct": false}], "correct_answer": "A. Optical Coherence Tomography (OCT)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/JG6OcTSd58CLYUEVnrhc1742977037.png", "https://image.prepladder.com/notes/BM0kcmFnvVs4S2ljEWq61742977587.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:728px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dry AMD</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Wet AMD</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnostic Methods</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Slit-lamp <span class=\"customMeta\" data-dictid=\"5eeb78465e1692777183b11db65160\">biomicroscopy</span> using a +90 or +78 D lens <strong>(Clinical diagnosis)</strong></li>\n<li>Optical Coherence <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">Tomography</span> (OCT): outer <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> tubulation is seen in the outer nuclear layer.</li>\n</ul>\n<img alt=\"-\" data-author=\"Fu, Haojie &amp; Zhang, Bin &amp; Tong, Jianliang &amp; Bedell, Harold &amp; Zhang, Hecheng &amp; Yang, Yating &amp; Nie, Chaochao &amp; Luo, Yingdong &amp; Liu, Xiaoling.\" data-hash=\"1801\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Optical-coherence-tomography-OCT-images-show-examples-of-lesions-in-different_fig1_319893795\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/JG6OcTSd58CLYUEVnrhc1742977037.png\"/>\n<ul>\n<li>Fundus autofluorescence</li>\n<li>Amsler <span class=\"customMeta\" data-dictid=\"440df3f37a16927771883b385ce82d\">grid</span> test</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Slit-lamp <span class=\"customMeta\" data-dictid=\"5eeb78465e1692777183b11db65160\">biomicroscopy</span> using a +90 or +78 D lens</li>\n<li>Optical Coherence <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">Tomography</span> (OCT) <strong>(Most sensitive): </strong>RPE <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> is seen.</li>\n</ul>\n<img alt=\"-\" data-author=\"Fu, Haojie &amp; Zhang, Bin &amp; Tong, Jianliang &amp; Bedell, Harold &amp; Zhang, Hecheng &amp; Yang, Yating &amp; Nie, Chaochao &amp; Luo, Yingdong &amp; Liu, Xiaoling.\" data-hash=\"1805\" data-license=\"CC BY 4.0\" data-source=\"https://www.researchgate.net/figure/Optical-coherence-tomography-OCT-images-show-examples-of-lesions-in-different_fig1_319893795\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/BM0kcmFnvVs4S2ljEWq61742977587.png\"/>\n<ul>\n<li>Fluorescein angiography</li>\n<li>Indocyanine green angiography</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Options</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>AREDS supplements (vitamins C, E, zinc, copper, lutein, zeaxanthin)</li>\n<li>Lifestyle modifications (smoking cessation, healthy diet)</li>\n<li>Regular monitoring to prevent <span class=\"customMeta\" data-dictid=\"3c305b384216927771969ca4166493\">progression</span> to advanced disease</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Intravitreal anti-VEGF injections (e.g., bevacizumab, ranibizumab, aflibercept)</li>\n<li>Photodynamic therapy (in select cases)</li>\n<li>Rarely, laser <span class=\"customMeta\" data-dictid=\"10cb4498ea1692777195b60ee356a3\">photocoagulation</span> (for extrafoveal CNV)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DETsZ9E0PDW9Hsbq7Yiu1746677698.mp3", "video": ""}, {"text": "A 72-year-old man presents with gradual vision loss in both eyes over the past year. His ophthalmologist diagnoses him with age-related macular degeneration (AMD). Which of the following statements about AMD is correct?", "options": [{"label": "A", "text": "AMD is a hereditary degeneration exclusively affecting the macula", "correct": false}, {"label": "B", "text": "Wet AMD accounts for 90% of all AMD cases but only 10% of severe vision loss", "correct": false}, {"label": "C", "text": "Dry AMD is characterised by choroidal neovascularisation", "correct": false}, {"label": "D", "text": "AMD is the most common cause of permanent central visual loss after 6th decade", "correct": true}], "correct_answer": "D. AMD is the most common cause of permanent central visual loss after 6th decade", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/wDdKKQs7dNY2XdAjFaBr1742977107.png", "https://image.prepladder.com/notes/BgTf4bbZ0dW7aUcGpOF81742977137.png", "https://image.prepladder.com/notes/bfl2CYBYCnGWCUc7eXYz1742977224.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dry AMD</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Wet AMD</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Nonexudative <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> degeneration</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Exudative <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> degeneration</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prevalence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>90% of all AMD cases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>10% of all AMD cases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vision Loss</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Accounts for about 10% of legal <span class=\"customMeta\" data-dictid=\"cf284485b71692777183c57876bed2\">blindness</span> in AMD</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Major <span class=\"customMeta\" data-dictid=\"f661999c4216927771834834296524\">blinding</span> form, accounts for 90% of severe vision loss in AMD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Drusen, <span class=\"customMeta\" data-dictid=\"142f8e4f971692777197f051738400\">RPE</span> abnormalities, <span class=\"customMeta\" data-dictid=\"64f5c141d51692777188eb378afc37\">geographic</span> atrophy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Choroidal <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> (CNV), <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> fluid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Accumulation of drusen, <span class=\"customMeta\" data-dictid=\"3662597407169277718640a12868f5\">dysfunction</span> of RPE</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Growth of new blood vessels from choroid, leakage of fluid</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Progression</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Generally slow</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can be rapid</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/L0Ghsofe3Eo2CLZHcD1K1746673588.mp3", "video": ""}, {"text": "Which of the following statements about angioid streaks is incorrect?", "options": [{"label": "A", "text": "They represent breaks in Bruch's membrane", "correct": false}, {"label": "B", "text": "They are commonly associated with sickle cell anemia", "correct": false}, {"label": "C", "text": "Choroidal neovascularization (CNV) frequently develops in these patients", "correct": false}, {"label": "D", "text": "Steroids are primarily used for the prevention of CNV", "correct": true}], "correct_answer": "D. Steroids are primarily used for the prevention of CNV", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/U3g304cfC3mdkYyOgyT81742976888.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:595px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Crack-like dehiscences in Bruch's membrane, appearing as reddish-brown or gray lines radiating from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Association with conditions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Pseudoxanthoma elasticum (PXE) - <strong>Most common</strong></li>\n<li>Ehlers-Danlos syndrome</li>\n<li>Paget's disease</li>\n<li>Sickle cell disease<strong> (Option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complication </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Choroidal <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> (CNV) frequently develops in affected patients <strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anti-VEGF therapy for <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> neovascularization</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kaUJW5QLh1tCCLjGvpW31746673085.mp3", "video": ""}, {"text": "A 28-year-old woman with a history of high myopia since childhood presents for a routine eye examination. She reports occasional floaters and difficulty seeing at night. On fundus examination, the ophthalmologist notes a tilted optic disc, peripapillary atrophy, and a myopic crescent. Which of the following is NOT typically associated with the condition?", "options": [{"label": "A", "text": "Foster-Fuchs spots", "correct": false}, {"label": "B", "text": "Lattice degeneration", "correct": false}, {"label": "C", "text": "Posterior staphyloma", "correct": false}, {"label": "D", "text": "Optic disc edema", "correct": true}], "correct_answer": "D. Optic disc edema", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/mHzcso5cKCysRtPBI6mf1742974511.png", "https://image.prepladder.com/notes/62R7R0E9HcpJ1hbgXLJs1742974514.png", "https://image.prepladder.com/notes/fVraACp9Fz7C2g4J6Rsl1742974514.png", "https://image.prepladder.com/notes/YoS8X2nMTQNdzLZxtCLi1742974516.png", "https://image.prepladder.com/notes/tEQSffbvnRkGKfzi8r1O1742974517.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pathological/degenerative/progressive <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> is a rapidly progressive error that starts in childhood at 5-10 years of age and results in high <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (&gt;-6D) during early adult life.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Rapid <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> growth of the <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> outside normal biological variations</li>\n<li>Genetic factors (major role)\n\t\t\t\t<ul>\n<li>More common in women than men</li>\n<li>Autosomal dominant <span class=\"customMeta\" data-dictid=\"c0c247b89916927771948bc5e6d39c\">pathological</span> myopia</li>\n<li>Heredity-\n\t\t\t\t\t<ul>\n<li>Familial, more common in women and in certain races</li>\n<li>Autosomal Dominant - <span class=\"customMeta\" data-dictid=\"8d0fca798b1692777191b6cd41880f\">linked</span> to genes 18p11.31 and 12q21-23</li>\n<li>Sex-linked <span class=\"customMeta\" data-dictid=\"d54db2110416927771971e7c011a9f\">recessive</span> - high <span class=\"customMeta\" data-dictid=\"619b89f28f16927771936b1ade010c\">myopia</span> (&gt;6D)</li>\n</ul>\n</li>\n</ul>\n</li>\n<li>General growth process (minor role)\n\t\t\t\t<ul>\n<li>nutritional deficiency</li>\n<li>endocrine disturbances</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Defective vision with considerable failure in visual function</li>\n<li>Muscae volitantes (floaters)</li>\n<li>Difficulty in <span class=\"customMeta\" data-dictid=\"3a81134c8a16927771936151d6b34e\">night vision</span> in very high myopes with degenerative changes</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prominent eyeballs, often appear elongated</li>\n<li>Exophthalmos, especially in <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> cases</li>\n<li>Cornea is large</li>\n<li>The <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber is deep</li>\n<li>Pupils are slightly large and react sluggishly to light</li>\n<li>Fundus examination reveals:\n\t\t\t\t<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc appears large and pale</li>\n<li>Characteristic myopic crescent</li>\n<li>Tigroid fundus</li>\n<li>Myopic <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> (temporal to disc margin)</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Retinal detachment</li>\n<li>Complicated cataract</li>\n<li>Choroidal <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> and neovascularization</li>\n<li>Vitreous hemorrhage</li>\n<li>Primary open-angle <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> (associated condition)</li>\n<li>Degenerative changes in the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> and choroid:\n\t\t\t\t<ul>\n<li>Chorioretinal <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">atrophy</span> at the macula</li>\n</ul>\n</li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"Ayman G Elnahry and Joseph H Talbet\" data-hash=\"1788\" data-license=\"CC BY 4.0\" data-source=\"https://juniperpublishers.com/jojo/JOJO.MS.ID.555709.php\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/mHzcso5cKCysRtPBI6mf1742974511.png\"/></p>\n<ul>\n<li>Foster-Fuchs spots <strong>(Option A)</strong></li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"Ayman G Elnahry and Joseph H Talbet\" data-hash=\"1789\" data-license=\"CC BY 4.0\" data-source=\"https://juniperpublishers.com/jojo/JOJO.MS.ID.555709.php\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/62R7R0E9HcpJ1hbgXLJs1742974514.png\"/></p>\n<ul>\n<li>Lattice degeneration<strong> (Option B)</strong></li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"-\" data-author=\"Robert E MorrisFerenc KuhnTimothy Sipos\" data-hash=\"1790\" data-license=\"CC BY-NC 3.0\" data-source=\"https://www.researchgate.net/figure/mage-of-pigmented-lattice-degeneration-at-the-equator-of-the-left-eye-treated-one-month_fig2_366534129\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/fVraACp9Fz7C2g4J6Rsl1742974514.png\"/></p>\n<p><img alt=\"-\" data-author=\"\" data-hash=\"1791\" data-license=\"\" data-source=\"\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/YoS8X2nMTQNdzLZxtCLi1742974516.png\"/></p>\n<ul>\n<li>Total <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> atrophy</li>\n</ul>\n<ul>\n<li>Posterior staphyloma<strong> (Option C) </strong></li>\n</ul>\n<p style=\"text-align: center;\"><img alt=\"-\" data-author=\"\" data-hash=\"1792\" data-license=\"\" data-source=\"\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/tEQSffbvnRkGKfzi8r1O1742974517.png\"/></p>\n<ul>\n<li>Degenerative changes in vitreous:\n\t\t\t\t<ul>\n<li>Liquefaction</li>\n<li>Vitreous opacities</li>\n<li>Posterior <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> detachment</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tIbnHGoXltVAsk2NOEN01746672733.mp3", "video": ""}, {"text": "A 65-year-old presents with visual blurring in the left eye, 20/40 vision, and a history of cataract surgery three months ago. Fundus examination shows retinal thickening and a dull foveal reflex. OCT and FFA findings are given below. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Diabetic Retinopathy", "correct": false}, {"label": "B", "text": "Central Retinal Vein Occlusion", "correct": false}, {"label": "C", "text": "Cystoid Macular Edema", "correct": true}, {"label": "D", "text": "Central Serous Retinopathy", "correct": false}], "correct_answer": "C. Cystoid Macular Edema", "question_images": ["https://image.prepladder.com/notes/Bfwy61vTPJDaFHfnyFIb1742974508.png", "https://image.prepladder.com/notes/yGAqcL1fu2BpmVxyF2wt1742974509.png"], "explanation_images": ["https://image.prepladder.com/notes/Bfwy61vTPJDaFHfnyFIb1742974508.png", "https://image.prepladder.com/notes/yGAqcL1fu2BpmVxyF2wt1742974509.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/A1nRzsE0q5eb0eg1HmzM1746672427.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 30 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - 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Tuberculosis", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not seen in very severe NPDR?", "options": [{"label": "A", "text": "Venous beading", "correct": false}, {"label": "B", "text": "Neovascularization of disc", "correct": true}, {"label": "C", "text": "Retinal hemorrhage", "correct": false}, {"label": "D", "text": "Microaneurysm", "correct": false}], "correct_answer": "B. Neovascularization of disc", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/OxGm8vVWZLplryvJQ8Vp1745926086.png", "https://image.prepladder.com/content/2kUFYxc2o7tVuDMhLeNI1745926095.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Severity </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Definition </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Very mild nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Microaneurysms only</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mild nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Microaneurysms plus hard exudates, <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, and/or mild <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Moderate nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Microaneurysms plus mild <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities or moderate <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Severe nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Any one</strong> of the following<strong> (4-2-1 Rule)</strong></p>\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages in four quadrants</li>\n<li>Venous <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> in at least two</li>\n<li>Moderately severe <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities (IRMA) in at least one quadrant</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Very severe nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Any two</strong> of the following <strong>(4-2-1 Rule)</strong></p>\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages in four quadrants <strong>(Option C ruled out)</strong></li>\n<li>Venous <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> in at least two <strong>(Option A ruled out)</strong></li>\n<li>Moderately severe <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities (IRMA) in at least one <span class=\"customMeta\" data-dictid=\"3a757d7c1216927771968223be411d\">quadrant</span> <strong>(Option D ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:675px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Early NPDR or Background <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Severe NPDR or Preproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> Retinopathy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Affects small <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> vessels.</li>\n<li><strong>Earliest sign:</strong> Microaneurysm\n\t\t\t\t<ul>\n<li><strong>Fluorescein <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">angiography</span> (FA):</strong> Tiny hyperfluorescent dots.</li>\n</ul>\n</li>\n<li><strong>Retinal hemorrhages: </strong>Both deep, i.e., in the inner nuclear or outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">plexiform</span> layer (dot and <span class=\"customMeta\" data-dictid=\"2bc990c16116927771830255971ff6\">blot</span> hemorrhage) and superficial, i.e., in nerve fiber layer (splinter or flame-shaped) hemorrhages</li>\n<li><strong>Hard exudates: </strong>\n<ul>\n<li>White or yellow <span class=\"customMeta\" data-dictid=\"b8ccccd9b81692777202ca2fa976d6\">waxy</span> patches with well-defined margins, often at the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole, in the outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">plexiform</span> layer.</li>\n<li><strong>FA: </strong>Hypofluorescence with dense exudates.</li>\n</ul>\n</li>\n<li>Edema is not marked.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Increased inner <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hypoxia:</strong> Leads to multiple <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages, <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> beading, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> loops, <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities (IRMAs), and large areas of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion.</li>\n<li><strong>Cotton-Wool Spots: </strong>\n<ul>\n<li>Also called soft exudates or nerve fiber infarcts.</li>\n<li>Result from ischemia, not exudation.</li>\n<li>Caused by <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of axoplasmic flow, leading to <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> and a white, fluffy appearance.</li>\n<li><strong>FA:</strong> <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">Focal</span> hypofluorescence due to local ischemia.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Venous Beading: </strong>\n<ul>\n<li>Indicates sluggish <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> circulation.</li>\n<li>Typically adjacent to large areas of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion. <strong>(Option D)</strong></li>\n</ul>\n</li>\n<li><strong>Intraretinal <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">Microvascular</span> Abnormalities (IRMA):</strong>\n<ul>\n<li>Dilated capillaries act as <span class=\"customMeta\" data-dictid=\"4de12d1ef31692777184db1d11c6bd\">collateral</span> channels.</li>\n<li>Bypass <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> bed and is often seen adjacent to <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion.</li>\n<li><strong>FA: </strong>Focal hypofluorescence</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"4167\" src=\"https://image.prepladder.com/content/OxGm8vVWZLplryvJQ8Vp1745926086.png\" width=\"4167\"/></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Mona Leeza, Humera Farooq\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Pathological-images-with-labelled-anomalies_fig1_332293685\" data-tags=\"\" height=\"4167\" src=\"https://image.prepladder.com/content/2kUFYxc2o7tVuDMhLeNI1745926095.png\" width=\"4167\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The image below displays the findings of a fundoscopy. What is the probable diagnosis?", "options": [{"label": "A", "text": "CRAO", "correct": true}, {"label": "B", "text": "CRVO", "correct": false}, {"label": "C", "text": "Diabetic retinopathy", "correct": false}, {"label": "D", "text": "Cystoid macular edema", "correct": false}], "correct_answer": "A. CRAO", "question_images": ["https://image.prepladder.com/content/EN8rPN9Mx4UlEHye5Jlo1746430571.png"], "explanation_images": ["https://image.prepladder.com/content/JN6tXucghsNHfitXDWJi1746430635.png", "https://image.prepladder.com/content/EXY1UboEOGq2bCO8nPhB1746430664.png", "https://image.prepladder.com/content/00gO7ihnj7W9I5AxroRl1746433577.png"], "explanation": "<p>Correct Answer A - CRAO\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a three-year-old boy, his parents have noticed a progressive decline in coordination over the last six months. During a physical examination, a growth resembling a cauliflower is observed in the left eye, along with leukocoria and the absence of a red reflex. Microscopic analysis of the sample reveals the presence of Flexner-Wintersteiner rosettes. Which gene is associated with this condition?", "options": [{"label": "A", "text": "Rb gene", "correct": true}, {"label": "B", "text": "ATP 7B gene", "correct": false}, {"label": "C", "text": "Rhodopsin gene", "correct": false}, {"label": "D", "text": "FBN 1 gene", "correct": false}], "correct_answer": "A. Rb gene", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/djeLevJ17QUjKt6rWlaR1746431736.png"], "explanation": "<p>Correct Answer A - Rb gene</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li><strong>Flexner-Wintersteiner rosettes (highly specific)-</strong><strong> </strong>These are composed of an ‘empty’ <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> surrounded by columnar cells</li>\n<li><strong>Homer-Wright rosettes</strong> - These are pseudo-rosettes and consist of cells surrounding a central <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> made up of their processes</li>\n<li>Undifferentiated tumor cells</li>\n<li>Areas of <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and calcification</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Leukocoria (60%)</li>\n<li>Strabismus (20%)</li>\n<li>Painful red eye (7%)</li>\n<li>Poor vision (5%)</li>\n<li>Asymptomatic (3%)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fundus Examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>White, elevated mass in the retina</li>\n<li>Can be endophytic, exophytic, or mixed growth</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>CT scan:</strong> <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">Calcification</span> in 90% of cases</li>\n<li><strong>MRI:</strong> Better for evaluating <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve and <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> extension</li>\n<li><strong>Ultrasound:</strong> Useful for initial screening</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Genetic Testing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>RB1 gene </strong>mutation on <span class=\"customMeta\" data-dictid=\"7157c1f59916927771846116d74646\">chromosome</span> 13q14</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the listed conditions is associated with the presence of punched-out lesions on the retina?", "options": [{"label": "A", "text": "Posterior staphyloma", "correct": false}, {"label": "B", "text": "Fundal coloboma", "correct": false}, {"label": "C", "text": "Congenital Rubella", "correct": false}, {"label": "D", "text": "Toxoplasmosis", "correct": true}], "correct_answer": "D. Toxoplasmosis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/WyIB9RNlkXNirtsgJlIp1745301434.png", "https://image.prepladder.com/notes/Ck3g69Pjfjv2LDiJTVL61745301843.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely cause of sudden loss of vision in the left eye for the past two hours in a 58-year-old man who experienced it after his retirement party? The fundoscopic examination reveals a similar image shown below.", "options": [{"label": "A", "text": "BRAO", "correct": false}, {"label": "B", "text": "CRAO", "correct": true}, {"label": "C", "text": "CRVO", "correct": false}, {"label": "D", "text": "BRVO", "correct": false}], "correct_answer": "B. CRAO", "question_images": ["https://image.prepladder.com/content/FfDJ8jHgFRKtPlX1QijC1745921659.png"], "explanation_images": ["https://image.prepladder.com/content/pld9ZdE9QOZOzjd2cOMH1745921865.png", "https://image.prepladder.com/content/MP147zfSaRpQwYdpvnuN1745921859.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Atherosclerosis</li>\n<li>Age</li>\n<li>Hypertension/Cardiac Diseases</li>\n<li>Thrombophilic Disorders</li>\n<li>Smoking</li>\n<li>Diabetes Mellitus</li>\n<li>Oral Contraceptive Pills</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Symptoms:</strong></p>\n<ul>\n<li><strong>Sudden, painless, profound vision loss</strong>.</li>\n<li>Painful only in GCA: May present with headache, jaw claudication, <span class=\"customMeta\" data-dictid=\"038a2a2fd4169277719894dc7db4bb\">scalp</span> tenderness, and/or pain around the temple.</li>\n</ul>\n<p> </p>\n<p><strong>Clinical Signs:</strong></p>\n<ul>\n<li>Severely <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> Visual Acuity (VA), often to <span class=\"customMeta\" data-dictid=\"e58c34390016927771859e87c91ed7\">counting</span> fingers or worse.</li>\n<li>Profound and sometimes total Relative Afferent Pupillary Defect (RAPD), also called an amaurotic pupil.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Examination Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fundus Examination:</strong></p>\n<ul>\n<li>Retinal Whitening: Pale and <span class=\"customMeta\" data-dictid=\"1b8aa0db391692777194178f73c98c\">opaque</span> retina, particularly in the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole.</li>\n<li><strong>Cherry-Red Spot: </strong>Bright red area at the <span class=\"customMeta\" data-dictid=\"82c2ec751816927772034d164bf755\">fovea</span> due to the contrast between pale <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> and underlying <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> circulation.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Dr. Gopal Bisht\" data-hash=\"\" data-license=\"CC BY-SA 4.0\" data-source=\"https://commons.wikimedia.org/wiki/File:Cherry_red_spot_in_patient_with_central_retinal_artery_occlusion_(CRAO).jpg\" data-tags=\"\" height=\"498\" src=\"https://image.prepladder.com/content/pld9ZdE9QOZOzjd2cOMH1745921865.png\" width=\"642\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Cattle Truck Appearance:</strong> Segmentation of the blood column in <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> veins.</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Leo A. Kim, MD, PhD, Mary Elizabeth Hartnett, MD, Marianna Kavalaraki MD, Msc, Neelakshi Bhagat, MD, FACS, Cindy S. Zhao, MD, MBA, Avni Finn, MD, MBA\" data-hash=\"\" data-license=\"NA\" data-source=\"https://eyewiki.org/Cherry-Red_Spot\" data-tags=\"\" height=\"480\" src=\"https://image.prepladder.com/content/MP147zfSaRpQwYdpvnuN1745921859.png\" width=\"647\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<ul>\n<li>Attenuated Arteries: Narrowed and segmented <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> arterioles.</li>\n<li>Optic Disc Changes: Pale <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc over time due to <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> <span class=\"customMeta\" data-dictid=\"97ff5253fb169277718224c7b0faf8\">atrophy</span> from prolonged <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">ischemia</span> (chronic cases).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fluorescein Angiography (FFA):</strong></p>\n<ul>\n<li>Delayed arterial filling.</li>\n<li>Masking of background <span class=\"customMeta\" data-dictid=\"da0e2a00fa1692777202d6e2054b26\">fluorescence</span> due to edematous retina.</li>\n<li><strong>Patent <span class=\"customMeta\" data-dictid=\"1e99ed05df169277718456b9311c0d\">Cilioretinal</span> Artery:</strong> Area of normal <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> of a <span class=\"customMeta\" data-dictid=\"1e99ed05df169277718456b9311c0d\">cilioretinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> supplies the fovea, potentially preserving central vision.</li>\n</ul>\n<p><strong>Other Diagnostic Tests:</strong></p>\n<ul>\n<li>Retinal edema, structural changes, and possibly an <span class=\"customMeta\" data-dictid=\"acd7af7f74169277718736b038fb02\">embolic</span> <span class=\"customMeta\" data-dictid=\"af71c1668e169277719542cf8f1364\">plaque</span> within the <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> artery.</li>\n<li>Cranial MRI or CT.</li>\n<li>Carotid duplex scanning.</li>\n<li>Echocardiography.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Smoking cessation</li>\n<li>Ocular massage</li>\n<li>IOP control agents: Acetazolamide</li>\n<li>Hyperosmotics: Mannitol</li>\n<li>Carbogen (95% O2 + 5% CO2) inhalation</li>\n<li>Nd-YAG laser embolectomy</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A male patient, aged 18, seeks medical attention due to an eye injury sustained while climbing a tree five days ago. The patient reports experiencing pain, sensitivity to light (photophobia), and redness in the affected eye for the past two days. Upon performing a slit-lamp examination, a lesion is observed as depicted below. Which of the following characteristics is associated with this particular condition?", "options": [{"label": "A", "text": "Reverse hypopyon", "correct": false}, {"label": "B", "text": "Dendritic ulcer", "correct": false}, {"label": "C", "text": "Ring abscess", "correct": false}, {"label": "D", "text": "Satellite lesion", "correct": true}], "correct_answer": "D. Satellite lesion", "question_images": ["https://image.prepladder.com/content/KnukzZE2alxYhP023ISZ1745923939.png"], "explanation_images": ["https://image.prepladder.com/content/Dl0Lh5iN7GOuuA9vjqWv1745924001.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:612px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li>Causative organism: <strong>Aspergillus fumigatus</strong> &gt;&gt; Fusarium</li>\n<li>Predisposing factor: <strong>Vegetative matter injury</strong> (trauma)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>SIGNS &gt;&gt; symptoms</strong></li>\n<li>Pain &amp; Foreign Body Sensation</li>\n<li>Watering/ Photophobia</li>\n<li>Blurred Vision, Redness</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Examination Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Corneal Ulcer:</strong> <strong>Greyish-white</strong>, dry, elevated, rolled-out margins</li>\n<li><strong>Pigmented Ulcer:</strong> Brownish, <span class=\"customMeta\" data-dictid=\"0f22e5402f16927771853bb4b7b234\">dematiaceous</span> fungi</li>\n<li><strong>Feathery Extensions:</strong> Finger-like projections in stroma</li>\n<li><strong>Sterile Immune Ring: </strong>Yellow line of demarcation</li>\n<li><strong>Satellite Lesions (Option D): </strong>Small lesions around the main ulcer</li>\n<li><strong>Hypopyon:</strong> <strong>Large, immobile, non-sterile</strong>, even in small ulcer</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"M. Upadhyay, M. Srinivasan, J. Whitcher\" data-hash=\"\" data-license=\"NA\" data-source=\"Figure 1 from Diagnosing and managing microbial keratitis | Semantic Scholar\" data-tags=\"\" height=\"233\" src=\"https://image.prepladder.com/content/Dl0Lh5iN7GOuuA9vjqWv1745924001.png\" width=\"311\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Corneal Scraping: For microbiological examination</li>\n<li><strong>Wet KOH Mount:</strong> Filamentous <span class=\"customMeta\" data-dictid=\"5ab0081e8316927772037e0f7c5a79\">fungi</span> or yeast-like <span class=\"customMeta\" data-dictid=\"5ab0081e8316927772037e0f7c5a79\">fungi</span> (Candida)</li>\n<li>Culture: <strong>Sabouraud's agar</strong> for fungal culture</li>\n<li>PCR: For rapid identification of pathogens</li>\n<li>Corneal Biopsy: For deep stromal <span class=\"customMeta\" data-dictid=\"5618681fbe16927771804370383aaa\">abscess</span> or negative cultures</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Topical Antifungal Agents:</strong> <strong>Natamycin 5%</strong>, Voriconazole, Amphotericin-B, Nystatin</li>\n<li><strong>Oral Antifungal Agents:</strong> Ketoconazole, <strong>Voriconazole</strong> (for severe ulcers)</li>\n<li><strong>Surgical Management:</strong>\n<ul>\n<li>Repeated Scraping: Removal of necrotic material</li>\n<li><strong>Cauterization Options:</strong> Carbolic acid (100%), Trichloroacetic acid (10%–20%), Povidone-iodine (5%)</li>\n<li>Therapeutic Keratoplasty: Corneal transplantation</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis for a 7-year-old boy who showed a white pupillary reflex and underwent enucleation, with histopathological examination showing Flexner Wintersteiner rosettes?", "options": [{"label": "A", "text": "Retinoblastoma", "correct": true}, {"label": "B", "text": "Medulloblastoma", "correct": false}, {"label": "C", "text": "Rhabdomyosarcoma", "correct": false}, {"label": "D", "text": "Astrocytoma", "correct": false}], "correct_answer": "A. Retinoblastoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/pRTSX3YcGgxp6XbGO8uz1745924432.png", "https://image.prepladder.com/content/kbSlB77qtRaB5yNNNtVf1745924448.png", "https://image.prepladder.com/content/jJEi1Xp1P1PkufxGABID1745924452.png", "https://image.prepladder.com/content/pK8u8jMifYf2oK3N9y661745924402.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li><strong>Leukocoria</strong> (60%)</li>\n<li><strong>Strabismus</strong> (20%)</li>\n<li>Painful red eye (7%)</li>\n<li>Poor vision (5%)</li>\n<li>Asymptomatic (3%)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fundus Examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>White, elevated mass in the retina</li>\n<li>Can be endophytic, exophytic, or mixed growth</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>CT scan: <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">Calcification</span> in 90% of cases</li>\n<li>MRI: Better for evaluating <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve and <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> extension</li>\n<li>Ultrasound: Useful for initial screening</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Flexner-Wintersteiner rosettes (highly specific): </strong>These are composed of an ‘empty’ <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> surrounded by columnar cells</li>\n<li><strong>Homer-Wright rosettes: </strong>These are pseudo-rosettes and consist of cells surrounding a central <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> made up of their processes</li>\n<li>Undifferentiated tumor cells</li>\n<li>Areas of <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and calcification</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Genetic Testing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>RB1 gene</strong> <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> on <span class=\"customMeta\" data-dictid=\"7157c1f59916927771846116d74646\">chromosome</span> <strong>13q14</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the condition characterized by painless vision loss?", "options": [{"label": "A", "text": "Central retinal arterial occlusion", "correct": false}, {"label": "B", "text": "Branched retinal artery occlusion", "correct": false}, {"label": "C", "text": "Central retinal vein occlusion", "correct": true}, {"label": "D", "text": "Branched retinal vein occlusion", "correct": false}], "correct_answer": "C. Central retinal vein occlusion", "question_images": ["https://image.prepladder.com/content/jAQcyPb9JWDbRgLgxbYF1746103041.png"], "explanation_images": ["https://image.prepladder.com/content/TlILQJuNTBM7uK9GMN2X1746103095.png", "https://image.prepladder.com/content/JgoWfy1VV7JN6GeL68dl1746103095.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Risk Factors</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Age <strong>&gt; 50 years</strong> (primary risk factor), <strong>Hypertension</strong>, Diabetes Mellitus, Hyperlipidemia, <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">Glaucoma</span> (increased IOP), Smoking, Hypercoagulable states</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pathogenesis</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Thrombosis driven by <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> stasis, endothelial damage, and hypercoagulability</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-ischemic CRVO</strong> (Venous <span class=\"customMeta\" data-dictid=\"ea73ce564216927771989ea1aa2c3d\">stasis</span> retinopathy) (75% of cases)</p>\n<ul>\n<li>Mild to moderate, <strong>unilateral blurring of vision </strong></li>\n<li>Fundus: Mild <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"2dd9736fdf16927771849f5a925f7d\">congestion</span> and tortuosity, flame-shaped hemorrhages, mild <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ischemic CRVO</strong> (Hemorrhagic retinopathy)</p>\n<ul>\n<li>Severe, <strong>sudden visual loss</strong>, massive <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> engorgement, <strong>\"splashed-tomato\" </strong>hemorrhages, cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots, <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</li>\n<li>Marked <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> sheathing, collaterals, neovascularization, chronic <span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\">cystoid</span> edema</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Sagnik Sen, Mukesh Patil, Rohit Saxena\" data-hash=\"\" data-license=\"Na\" data-source=\"https://www.researchgate.net/figure/Tomato-splashed-appearance-in-CRVO_fig4_313965605\" data-tags=\"\" height=\"248\" src=\"https://image.prepladder.com/content/TlILQJuNTBM7uK9GMN2X1746103095.png\" width=\"409\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Investigations</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Ocular Exam: Visual acuity, IOP, Slit-lamp exam (NVI), Gonioscopy (NVA)</li>\n<li><strong>Goldmann Perimetry and ERG: </strong>Differentiating ischemic vs non-ischemic CRVO</li>\n<li><strong>Fundus Fluorescein Angiography (FFA):</strong> Assess <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> perfusion</li>\n<li><strong>Optical Coherence Tomography (OCT): </strong>Assess <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, sub-retinal fluid</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Systemic Management:</strong> Control of <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> conditions (hypertension, diabetes, hyperlipidemia, hyperhomocysteinemia)</li>\n<li><strong>Medical Treatment: <span class=\"customMeta\" data-dictid=\"67c9bce29d169277719036007848c0\">Intravitreal</span> anti-VEGF (e.g., Bevacizumab)</strong>, <span class=\"customMeta\" data-dictid=\"67c9bce29d169277719036007848c0\">intravitreal</span> steroids (Triamcinolone, Dexamethasone implant)</li>\n<li><strong>Laser Therapy: Panretinal <span class=\"customMeta\" data-dictid=\"10cb4498ea1692777195b60ee356a3\">photocoagulation</span> (PRP) </strong>for neovascularization</li>\n<li>Surgical: Pars <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> <span class=\"customMeta\" data-dictid=\"e6aa17c07816927772024116d41015\">vitrectomy</span> for complications</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Neovascular glaucoma, <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">Neovascularization</span> of the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> (NVI), Vitreous hemorrhage, Proliferative retinopathy, Chronic <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following parts of the retina are correctly marked?", "options": [{"label": "A", "text": "1-Retinal pigment epithelium; 2-Outer nuclear layer; 3-Inner plexiform layer; 4-Ganglion layer B) 1-Retinal pigment epithelium; 2-Inner nuclear layer; 3-Outer plexiform layer; 4-Ganglion layer C) 1-Ganglion layer; 2-Inner nuclear layer; 3-Outer plexiform layer; 4-RPE D) 1-Ganglion layer; 2-Outer plexiform layer; 3-Inner nuclear layer; 4-RPE", "correct": true}, {"label": "B", "text": "1-Retinal pigment epithelium; 2-Inner nuclear layer; 3-Outer plexiform layer; 4-Ganglion layer", "correct": false}, {"label": "C", "text": "1-Ganglion layer; 2-Inner nuclear layer; 3-Outer plexiform layer; 4-RPE", "correct": false}, {"label": "D", "text": "1-Ganglion layer; 2-Outer plexiform layer; 3-Inner nuclear layer; 4-RPE", "correct": false}], "correct_answer": "A. 1-Retinal pigment epithelium; 2-Outer nuclear layer; 3-Inner plexiform layer; 4-Ganglion layer B) 1-Retinal pigment epithelium; 2-Inner nuclear layer; 3-Outer plexiform layer; 4-Ganglion layer C) 1-Ganglion layer; 2-Inner nuclear layer; 3-Outer plexiform layer; 4-RPE D) 1-Ganglion layer; 2-Outer plexiform layer; 3-Inner nuclear layer; 4-RPE", "question_images": ["https://image.prepladder.com/content/hVliXrZEBLjxE8nWIHsE1741789477.png"], "explanation_images": ["https://image.prepladder.com/content/262i3jl9peG0CsmpxEKK1741789501.png", "https://image.prepladder.com/content/4qEDb8J7FTVkrhd35yyh1741277659.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">Pigment</span> Epithelium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Outermost layer with a single <span class=\"customMeta\" data-dictid=\"85dafbf32f1692777195b9d9f035d8\">pigmented</span> cell layer; adheres to Bruch's membrane; supports <span class=\"customMeta\" data-dictid=\"0d7d7c885216927771935437653141\">neurosensory</span> retina, and reduces reflection.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subretinal Space:</strong> This is the layer between the <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">Pigment</span> <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> and the layer of Photoreceptors.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2. Rods and Cones Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contains the outer segments of <strong>photoreceptors (rods and cones, which are the first-order neurons)</strong>; rods detect low-light vision, cones manage color and detailed vision.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3. External Limiting Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"f2fe04f3c7169277719614074303ec\">porous</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> allows processes from rods and cones to pass through.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4. Outer Nuclear Layer</strong><br/>\n<strong>(Henle’s layer) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contains the <span class=\"customMeta\" data-dictid=\"e6b47028191692777193eb698e43b6\">nuclei</span> of the <span class=\"customMeta\" data-dictid=\"61b0f28598169277719523480b9ee4\">photoreceptor</span> cells (rods and cones).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5. Outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">Plexiform</span> Layer </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Includes connections between rods, cones, <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cell dendrites, and <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>6. Inner Nuclear Layer </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Made up of the<strong> </strong><strong>cell bodies of <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cells</strong><strong> (which are the second-order neurons)</strong>, <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> cells, <span class=\"customMeta\" data-dictid=\"91407dbf141692777181d103817280\">amacrine</span> cells, and Müller cells; and also contains <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> capillaries.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>7. Inner <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">Plexiform</span> Layer </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Houses <span class=\"customMeta\" data-dictid=\"5c4592475a1692777199991c761d11\">synaptic</span> connections between <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cell axons, <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">ganglion</span> cell dendrites, and <span class=\"customMeta\" data-dictid=\"91407dbf141692777181d103817280\">amacrine</span> cell processes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>8. <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">Ganglion</span> Cell Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contains <strong>ganglion cell bodies, which serve as third-order neurons</strong>; midget cells <span class=\"customMeta\" data-dictid=\"12a0ce16121692777199554dcff349\">synapse</span> with a single <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cell, and <span class=\"customMeta\" data-dictid=\"45adef7aa11692777196441a21222f\">polysynaptic</span> cells <span class=\"customMeta\" data-dictid=\"12a0ce16121692777199554dcff349\">synapse</span> with multiple.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>9. Nerve Fiber Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Composed of <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">ganglion</span> cell axons that <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve after passing through the <span class=\"customMeta\" data-dictid=\"9864ad42b21692777191febeee1002\">lamina</span> cribrosa.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>10. Internal Limiting Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The innermost layer separating the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> from the vitreous; is formed by the <span class=\"customMeta\" data-dictid=\"16b76d1d1c1692777200240efcb0e2\">terminal</span> expansions of Müller cells, serving as a basement membrane.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the primary mode of dissemination of retinoblastoma?", "options": [{"label": "A", "text": "Optic nerve invasion", "correct": false}, {"label": "B", "text": "Hematogenous", "correct": false}, {"label": "C", "text": "Direct invasion", "correct": true}, {"label": "D", "text": "Lymphatic spread", "correct": false}], "correct_answer": "C. Direct invasion", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>ICRB Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Small <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> tumors <strong>(&lt;3mm)</strong></li>\n<li>Located &gt;3 mm from the <span class=\"customMeta\" data-dictid=\"1d54a9ca8a16927772037b749264b0\">foveola</span> and &gt;1.5 mm from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</li>\n</ul>\n<p> </p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Laser photocoagulation: </strong>Posterior to equator</li>\n<li><strong>Cryotherapy:</strong> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> to equator</li>\n<li>Thermotherapy</li>\n<li>Chemoreduction <strong>(Etoposide, Vincristine and Carboplatin)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Large tumors <strong>&gt;3 mm</strong> in dimension</li>\n<li>Any size tumors located <strong>&lt;3 mm from fovea</strong>, and <strong>&lt;1.5 mm from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc margin</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chemoreduction + <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> consolidation</li>\n<li>Plaque radiotherapy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>C</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Subretinal seeds ≤ 3 mm</strong> from tumor</li>\n<li><strong>Vitreous seeds</strong> <strong>≤ 3 mm</strong> from tumor</li>\n<li>Both <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> and <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> seeds ≤ 3 mm from tumor</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Chemoreduction + <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> consolidation</li>\n<li>Possible <span class=\"customMeta\" data-dictid=\"67c9bce29d169277719036007848c0\">intravitreal</span> <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> for <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> seeding</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>D</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Subretinal seeds &gt; 3 mm</strong> from tumor</li>\n<li><strong>Vitreous seeds &gt; 3 mm</strong> from tumor</li>\n<li>Both <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> and <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> seeds &gt; 3 mm from retinoblastoma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Chemoreduction + possible <span class=\"customMeta\" data-dictid=\"67c9bce29d169277719036007848c0\">intravitreal</span> chemotherapy</strong></li>\n<li>External beam <span class=\"customMeta\" data-dictid=\"a75f060aa1169277719777dd69df3f\">radiotherapy</span> in some cases</li>\n<li>Enucleation if poor response to other treatments</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>E</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Extensive <span class=\"customMeta\" data-dictid=\"fc941081ef16927771970c709f1103\">retinoblastoma</span> occupying <strong>&gt; 50% of the globe</strong> with or without:</p>\n<ul>\n<li>Neovascular glaucoma</li>\n<li>Hemorrhage</li>\n<li>Extension of tumor to <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve or <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Enucleation</strong></li>\n<li>Possible <span class=\"customMeta\" data-dictid=\"1a38e9a3321692777180b2468ff799\">adjuvant</span> <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> if high-risk features</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most probable diagnosis for a 7-year-old patient who presented with a white pupillary reflex and underwent enucleation, with histopathological examination revealing the presence of Flexner Wintersteiner rosettes?", "options": [{"label": "A", "text": "Retinoblastoma", "correct": true}, {"label": "B", "text": "Medulloblastoma", "correct": false}, {"label": "C", "text": "Rhabdomyosarcoma", "correct": false}, {"label": "D", "text": "Astrocytoma", "correct": false}], "correct_answer": "A. Retinoblastoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/T604PqLUcKQdVQKY4Cnq1745415673.png", "https://image.prepladder.com/content/L6ZIS7FdNPqEplgQHe8J1745415722.png"], "explanation": "<p>Correct Answer A - Retinoblastoma</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<ul>\n<li><strong>Leukocoria</strong> (60%)</li>\n<li><strong>Strabismus</strong> (20%)</li>\n<li>Painful red eye (7%)</li>\n<li>Poor vision (5%)</li>\n<li>Asymptomatic (3%)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Fundus Examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>White, elevated mass in the retina</li>\n<li>Can be endophytic, exophytic, or mixed growth</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>CT scan: <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">Calcification</span> in 90% of cases</li>\n<li>MRI: Better for evaluating <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve and <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> extension</li>\n<li>Ultrasound: Useful for initial screening</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Flexner-Wintersteiner rosettes (highly specific): </strong>These are composed of an ‘empty’ <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> surrounded by columnar cells</li>\n<li><strong>Homer-Wright rosettes: </strong>These are pseudo-rosettes and consist of cells surrounding a central <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> made up of their processes</li>\n<li>Undifferentiated tumor cells</li>\n<li>Areas of <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and calcification</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Genetic Testing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>RB1 gene</strong> <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> on <span class=\"customMeta\" data-dictid=\"7157c1f59916927771846116d74646\">chromosome</span> <strong>13q14</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Shifting fluid sign is seen in?", "options": [{"label": "A", "text": "Exudative retinal detachment", "correct": true}, {"label": "B", "text": "Traction retinal detachment", "correct": false}, {"label": "C", "text": "Rhegmatogenous retinal detachment", "correct": false}, {"label": "D", "text": "Retinal dialysis", "correct": false}], "correct_answer": "A. Exudative retinal detachment", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/7AxS0SwJxYwhCD6HUvpn1745239641.png", "https://image.prepladder.com/content/LuGLmymLl17KNlmcHZjE1745239648.png", "https://image.prepladder.com/content/0xRYAy1SFAca6Vfrzh1O1745239655.png", "https://image.prepladder.com/content/APHaH5sIoUcPOwSJ8LSH1745239663.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type of <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clinical Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rhegmatogenous <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">Detachment</span> </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1.<strong> <span class=\"customMeta\" data-dictid=\"77d71e88de1692777202d4f0a3f63e\">Floaters</span> </strong>(dark spots) due to rapid <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> degeneration.</p>\n<p>2.<strong> <span class=\"customMeta\" data-dictid=\"70b2c73b8d169277719545acd7fe2e\">Photopsia</span> </strong>(flashes of light) caused by <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"3a74ed0fcf16927771901a79847565\">irritation</span> from <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> movements.</p>\n<p>3. Gradual <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> loss, initially localized, progressing to total vision loss as <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> spreads.</p>\n<p>4.<strong> Dark veil/cloud in front of the eye</strong>, particularly when <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> reaches the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> region.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NYC Wanderer (Kevin Eng) \" data-hash=\"\" data-license=\"CC BY-SA 2.0\" data-source=\"https://en.wikipedia.org/wiki/Book#/media/File:Gutenberg_Bible,_Lenox_Copy,_New_York_Public_Library,_2009._Pic_01.jpg\" data-tags=\"\" height=\"300\" src=\"https://image.prepladder.com/content/7AxS0SwJxYwhCD6HUvpn1745239641.png\" width=\"434\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p>5. Sudden, painless vision loss in large, central detachment.</p>\n<p>6. <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> breaks may be round, horseshoe-shaped, slit-like, or large <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> dialysis.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Jesse Vislisel, MD\" data-hash=\"\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://eyerounds.org/atlas/pages/rhegmatogenous-ret-detach.htm#gsc.tab=0\" data-tags=\"\" height=\"311\" src=\"https://image.prepladder.com/content/LuGLmymLl17KNlmcHZjE1745239648.png\" width=\"436\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p>7. <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">Vitreous</span> pigments (tobacco dusting or <strong>Shaffer sign</strong>) are seen in the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> detachment.</p>\n<p>8. Old <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> shows <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> thinning, <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> <span class=\"customMeta\" data-dictid=\"6e26f8de1c1692777185d8f3885a0c\">demarcation</span> lines (high water marks), and secondary <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> cysts.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">Detachment</span> </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Gradual, progressive visual loss</p>\n<p>2. Typically painless</p>\n<p>3. No associated flashes or floaters</p>\n<p>4.<strong> Vitreoretinal bands present</strong></p>\n<p>5. No <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> breaks</p>\n<p>6. Detached area - <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> and localized</p>\n<p>7. No shifting fluid</p>\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"359\" src=\"https://image.prepladder.com/content/0xRYAy1SFAca6Vfrzh1O1745239655.png\" width=\"359\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exudative <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">Detachment</span> (Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. Painless and sudden or gradual visual loss</p>\n<p>2. No photopsia, holes/ tears, folds and undulations.</p>\n<p>3. Smooth and <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> with <span class=\"customMeta\" data-dictid=\"45d1f54a631692777195670b446c7e\">pigmentary</span> disturbances</p>\n<p>4. Rounded and fixed with <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> on the tumor summit.</p>\n<p>5.<strong> Shifting fluid </strong>- changing the position of the detached area with gravity - hallmark feature.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Henry Zou Lauren Fletcher-Morehouse\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Exudative-retinal-detachment-ERD-of-both-eyes-at-one-week-post-op_fig1_362643260\" data-tags=\"\" height=\"338\" src=\"https://image.prepladder.com/content/APHaH5sIoUcPOwSJ8LSH1745239663.png\" width=\"338\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most probable diagnosis for a 3-year-old boy who has displayed growing clumsiness over the last half a year, has leukocoria, and lacks red reflex in his left eye? After diagnosis, enucleation was performed, and the specimen displayed Flexner-Wintersteiner rosettes under microscopic examination?", "options": [{"label": "A", "text": "Congenital glaucoma", "correct": false}, {"label": "B", "text": "Retinoblastoma", "correct": true}, {"label": "C", "text": "Toxocariasis", "correct": false}, {"label": "D", "text": "Neurofibroma", "correct": false}], "correct_answer": "B. Retinoblastoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/9o42wU1BaSXr5wFNwuh81746704089.png", "https://image.prepladder.com/content/GcRqySblQV025GQwIdD71746704119.png"], "explanation": "<p>Correct Option B - R\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the condition in which the cherry red spot, as shown in the image below, is observed?", "options": [{"label": "A", "text": "Central retinal artery occlusion (CRAO)", "correct": true}, {"label": "B", "text": "Central retinal venous occlusion (CRVO)", "correct": false}, {"label": "C", "text": "Branched retinal artery occlusion (BRAO)", "correct": false}, {"label": "D", "text": "Branched retinal vein occlusion (BRVO)", "correct": false}], "correct_answer": "A. Central retinal artery occlusion (CRAO)", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/eFHwNIq2f9d4KNkEL8y61747042325.png", "https://image.prepladder.com/content/8Z6R0S6NY03gqQhdTzoi1747042336.png", "https://image.prepladder.com/content/Gr1wZcTjwo0Fm84PuptQ1748069820.png"], "explanation": "<p>Correct Option A - Central &lt;span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\"&gt;retinal&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\"&gt;artery&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\"&gt;occlusion&lt;/span&gt; (CRAO)\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In which diseases are microaneurysms observed?", "options": [{"label": "A", "text": "Retinal detachment", "correct": false}, {"label": "B", "text": "Diabetic retinopathy", "correct": true}, {"label": "C", "text": "Uveitis", "correct": false}, {"label": "D", "text": "Glaucoma", "correct": false}], "correct_answer": "B. Diabetic retinopathy", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/MEf6Nsh7x6qCTMcE8ydd1747042804.png", "https://image.prepladder.com/content/f9gtJaXpvFAWWfs0Kb4Z1747042812.png"], "explanation": "<p>Correct Option B - Diabetic retinopathy</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Early NPDR or Background Diabetic Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Severe NPDR or Preproliferative Diabetic Retinopathy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Affects small <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> vessels.</li>\n<li><strong>Earliest sign: Microaneurysm (Option B) </strong>\n<ul>\n<li><strong>Fluorescein <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">angiography</span> (FA):</strong> Tiny hyperfluorescent dots.</li>\n</ul>\n</li>\n<li><strong>Retinal hemorrhages: </strong>Both deep, i.e., in the inner nuclear or outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">plexiform</span> layer (dot and <span class=\"customMeta\" data-dictid=\"2bc990c16116927771830255971ff6\">blot</span> hemorrhage) and superficial, i.e., in nerve fiber layer (splinter or flame-shaped) hemorrhages</li>\n<li><strong>Hard exudates: </strong>\n<ul>\n<li>White or yellow <span class=\"customMeta\" data-dictid=\"b8ccccd9b81692777202ca2fa976d6\">waxy</span> patches with well-defined margins, often at the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole, in the outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">plexiform</span> layer.</li>\n<li><strong>FA: </strong>Hypofluorescence with dense exudates.</li>\n</ul>\n</li>\n<li>Edema is not marked.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Increased inner <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hypoxia:</strong> Leads to multiple <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages, <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> beading, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> loops, <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities (IRMAs), and large areas of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion.</li>\n<li><strong>Cotton-Wool Spots: </strong>\n<ul>\n<li>Also called soft exudates or nerve fiber infarcts.</li>\n<li>Result from ischemia, not exudation.</li>\n<li>Caused by <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of axoplasmic flow, leading to <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> and a white, fluffy appearance.</li>\n<li><strong>FA:</strong> <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">Focal</span> hypofluorescence due to local ischemia.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Venous Beading: </strong>\n<ul>\n<li>Indicates sluggish <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> circulation.</li>\n<li>Typically adjacent to large areas of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Intraretinal <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">Microvascular</span> Abnormalities (IRMA):</strong>\n<ul>\n<li>Dilated capillaries act as <span class=\"customMeta\" data-dictid=\"4de12d1ef31692777184db1d11c6bd\">collateral</span> channels.</li>\n<li>Bypass <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> bed and is often seen adjacent to <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion.</li>\n<li><strong>FA: </strong>Focal hypofluorescence</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"487\" src=\"https://image.prepladder.com/content/MEf6Nsh7x6qCTMcE8ydd1747042804.png\" width=\"487\"/></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Mona Leeza, Humera Farooq\" data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Pathological-images-with-labelled-anomalies_fig1_332293685\" data-tags=\"\" height=\"379\" src=\"https://image.prepladder.com/content/f9gtJaXpvFAWWfs0Kb4Z1747042812.png\" width=\"379\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "All of the following are causes for expanding blind spots, except for...", "options": [{"label": "A", "text": "POAG", "correct": false}, {"label": "B", "text": "Hypoplasia of optic disc", "correct": true}, {"label": "C", "text": "Papilledema", "correct": false}, {"label": "D", "text": "Medullated nerve fibres", "correct": false}], "correct_answer": "B. Hypoplasia of optic disc", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with a history of diabetes and hypertension underwent fundus fluorescent angiography (FFA) to evaluate his decreasing vision. The FFA yields an image as shown below, which is characteristic of :", "options": [{"label": "A", "text": "Macular ischemia", "correct": true}, {"label": "B", "text": "Macula edema", "correct": false}, {"label": "C", "text": "Submacular haemorrhage", "correct": false}, {"label": "D", "text": "Premacular haemorrhage", "correct": false}], "correct_answer": "A. Macular ischemia", "question_images": ["https://image.prepladder.com/content/1YTFJCg2NNVtaUQIRqJd1695807279.png"], "explanation_images": [], "explanation": "<p>Correct option A\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Condition</strong></p>\n</td>\n<td>\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Macular Ischemia</p>\n</td>\n<td>\n<p>Inadequate blood supply to the macula</p>\n<p>Enlarged foveal <span class=\"customMeta\" data-dictid=\"a44009963c1692777182feb479b12b\">avascular</span> zone</p>\n<p>Reduced <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> and oxygen delivery to the macula</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\">\n<p>Macular Edema</p>\n</td>\n<td>\n<p><strong>Can cause vision loss and <span class=\"customMeta\" data-dictid=\"4885d5d0021692777189aac6dc80f7\">impairment</span> of central vision</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Accumulation of fluid in the macula</p>\n<p>Swelling and <span class=\"customMeta\" data-dictid=\"eaec97de1d1692777186b2ce902b4d\">distortion</span> of central vision</p>\n<p>Can be caused by various conditions, including diabetes</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\">\n<p>Submacular Hemorrhage</p>\n<p> </p>\n</td>\n<td>\n<p><strong>Can lead to vision loss and blurred vision</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Bleeding underneath the macula</p>\n<p>Sudden and severe vision loss</p>\n<p>Can be caused by various conditions, such as AMD</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\">\n<p>Premacular Hemorrhage</p>\n</td>\n<td>\n<p><strong>Requires immediate medical attention</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Bleeding within the <span class=\"customMeta\" data-dictid=\"948746a830169277719140f9f93879\">macula</span> itself</p>\n<p>Acute vision loss</p>\n<p>Can be caused by trauma or <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> disorders</p>\n<p>Requires ophthalmological evaluation and management</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old hypertensive patient presented with complaints of blurred vision and headaches. On retinal examination, the following findings were observed: multiple flame-shaped hemorrhages, cotton wool spots, and disc edema. Based on the Keith-Wagner classification, which grade of hypertensive retinopathy is this patient most likely classified as?", "options": [{"label": "A", "text": "GRADE 1", "correct": false}, {"label": "B", "text": "GRADE 2", "correct": false}, {"label": "C", "text": "GRADE 3", "correct": false}, {"label": "D", "text": "GRADE 4", "correct": true}], "correct_answer": "D. GRADE 4", "question_images": [], "explanation_images": [], "explanation": "<table>\n<thead>\n<tr>\n<th><strong>Grade</strong></th>\n<th><strong>Fundus Findings</strong></th>\n<th><strong>Clinical Features</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>Grade 1</td>\n<td>Mild arteriolar narrowing</td>\n<td>Usually asymptomatic</td>\n</tr>\n<tr>\n<td>Grade 2</td>\n<td>Moderate arteriolar narrowing + AV nicking</td>\n<td>Often <span class=\"customMeta\" data-dictid=\"d1a9a79f701692777182066af09044\">asymptomatic</span> or mild symptoms</td>\n</tr>\n<tr>\n<td>Grade 3</td>\n<td>Grade 2 + Flame-shaped hemorrhages + Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots + hard exudates</td>\n<td>Visual symptoms possible</td>\n</tr>\n<tr>\n<td>Grade 4</td>\n<td>Grade 3 + Papilledema (disc edema)</td>\n<td>Malignant <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> symptoms like headache, blurred vision</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is incorrect about Retinitis Pigmentosa?", "options": [{"label": "A", "text": "ERG shows decreased amplitude of a and b waves B) Rod dystrophy &amp;gt; Cone dystrophy C) Late presentation is loss of peripheral vision D) Night vision is lost late and rare", "correct": false}, {"label": "B", "text": "Rod dystrophy &amp;gt; Cone dystrophy", "correct": false}, {"label": "C", "text": "Late presentation is loss of peripheral vision", "correct": false}, {"label": "D", "text": "Night vision is lost late and rare", "correct": true}], "correct_answer": "D. Night vision is lost late and rare", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/lPU21BoSMNcIJaFFYn591741275034.png", "https://image.prepladder.com/content/iSSy5j46Yc2DCo5QlfyW1741275064.png", "https://image.prepladder.com/content/Y50qRUq3cG2aUZK8JfhT1741275115.png", "https://image.prepladder.com/content/8TeyGCuzfjLUAw46WLkT1741275138.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is a complication of diabetic retinopathy?", "options": [{"label": "A", "text": "Posterior staphyloma", "correct": false}, {"label": "B", "text": "Retinoschisis", "correct": false}, {"label": "C", "text": "Tractional retinal detachment", "correct": true}, {"label": "D", "text": "Progressive myopia", "correct": false}], "correct_answer": "C. Tractional retinal detachment", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/fK8IKihYp2eiOxDzwXxs1741789787.png", "https://image.prepladder.com/content/n10qc2N2rCXvttTKsUYV1741789804.png", "https://image.prepladder.com/content/ueo9kZwODrwWXyNc8zPw1741279248.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is the diagnostic investigation for Best disease?", "options": [{"label": "A", "text": "EOG B) ERG C) Multifocal ERG D) Visual evoked potential", "correct": true}, {"label": "B", "text": "ERG", "correct": false}, {"label": "C", "text": "Multifocal ERG", "correct": false}, {"label": "D", "text": "Visual evoked potential", "correct": false}], "correct_answer": "A. EOG B) ERG C) Multifocal ERG D) Visual evoked potential", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KzZ7rDe5hcIkJ2rYcHSJ1741790327.png", "https://image.prepladder.com/content/tWoWA3QSzYvv2csa1mxd1741790352.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 3-month-old baby, born preterm at 33 weeks of gestation, is brought by parents with complaints of a white pupillary reflex for 2 weeks. CT revealed calcification of the globe in both eyes. What is the probable diagnosis?", "options": [{"label": "A", "text": "ROP (Retinopathy of Prematurity)", "correct": false}, {"label": "B", "text": "Retinoblastoma", "correct": true}, {"label": "C", "text": "Glaucoma", "correct": false}, {"label": "D", "text": "Congenital Cataract", "correct": false}], "correct_answer": "B. Retinoblastoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/7cJAY3ynKLSxwACsBnDn1741790416.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Flexner-Wintersteiner rosettes </strong><strong>(highly specific)-</strong><strong> </strong>These are composed of an ‘empty’ <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> surrounded by columnar cells</li>\n<li><strong>Homer-Wright rosettes</strong> - These are pseudo-rosettes and consist of cells surrounding a central <span class=\"customMeta\" data-dictid=\"e87def492e1692777191eda63cfc5e\">lumen</span> made up of their processes</li>\n<li>Undifferentiated tumor cells</li>\n<li>Areas of <span class=\"customMeta\" data-dictid=\"5e84a7987c16927771931012aced83\">necrosis</span> and calcification</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Presentation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Leukocoria (60%)</li>\n<li>Strabismus (20%)</li>\n<li>Painful red eye (7%)</li>\n<li>Poor vision (5%)</li>\n<li>Asymptomatic (3%)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fundus Examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>White, elevated mass in the retina</li>\n<li>Can be endophytic, exophytic, or mixed growth</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Imaging</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>CT scan:</strong> <span class=\"customMeta\" data-dictid=\"a1ee14c673169277718351bfe6afd4\">Calcification</span> in 90% of cases</li>\n<li><strong>MRI:</strong> Better for evaluating <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve and <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> extension</li>\n<li><strong>Ultrasound:</strong> Useful for initial screening</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Genetic Testing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>RB1 gene <span class=\"customMeta\" data-dictid=\"7a67bdf6f81692777193cfd480f228\">mutation</span> on <span class=\"customMeta\" data-dictid=\"7157c1f59916927771846116d74646\">chromosome</span> 13q14</p>\n</td>\n</tr>\n</tbody>\n\n<p><strong>Educational Objective:</strong></p>\n<ul><li>➤ Learning Objective:</li><li>➤ Staging and treatment of Retinoblastoma</li><li>➤ Staging and treatment of Retinoblastoma</li><li>➤ ICRB Stage Features Treatment A Small intraretinal tumors (&lt;3mm) Located &gt;3 mm from the foveola and &gt;1.5 mm from the optic disc Laser photocoagulation- Posterior to equator Cryotherapy- Anterior to equator Thermotherapy Chemoreduction (Etoposide, Vincristine and Carboplatin) B Large tumors &gt;3 mm in dimension Any size tumors located &lt;3 mm from fovea, and &lt;1.5 mm from the optic disc margin Chemoreduction + focal consolidation Plaque radiotherapy C Subretinal seeds ≤ 3 mm from tumor Vitreous seeds ≤ 3 mm from tumor Both subretinal and vitreous seeds ≤ 3 mm from tumor Chemoreduction + focal consolidation Possible intravitreal chemotherapy for vitreous seeding D Subretinal seeds &gt; 3 mm from tumor Vitreous seeds &gt; 3 mm from tumor Both subretinal and vitreous seeds &gt; 3 mm from retinoblastoma Chemoreduction + possible intravitreal chemotherapy External beam radiotherapy in some cases Enucleation, if poor response to other treatments E Extensive retinoblastoma occupying &gt; 50% of the globe with or without: Neovascular glaucoma Hemorrhage Extension of tumor to optic nerve or anterior chamber Enucleation Possible adjuvant chemotherapy if high-risk features</li><li>➤ ICRB Stage Features Treatment</li><li>➤ A Small intraretinal tumors (&lt;3mm) Located &gt;3 mm from the foveola and &gt;1.5 mm from the optic disc Laser photocoagulation- Posterior to equator Cryotherapy- Anterior to equator Thermotherapy Chemoreduction (Etoposide, Vincristine and Carboplatin)</li><li>➤ Small intraretinal tumors (&lt;3mm) Located &gt;3 mm from the foveola and &gt;1.5 mm from the optic disc</li><li>➤ Small intraretinal tumors (&lt;3mm) Located &gt;3 mm from the foveola and &gt;1.5 mm from the optic disc</li><li>➤ Small intraretinal tumors (&lt;3mm)</li><li>➤ Located &gt;3 mm from the foveola and &gt;1.5 mm from the optic disc</li><li>➤ Laser photocoagulation- Posterior to equator Cryotherapy- Anterior to equator Thermotherapy Chemoreduction (Etoposide, Vincristine and Carboplatin)</li><li>➤ Laser photocoagulation- Posterior to equator Cryotherapy- Anterior to equator Thermotherapy Chemoreduction (Etoposide, Vincristine and Carboplatin)</li><li>➤ Laser photocoagulation- Posterior to equator</li><li>➤ Laser photocoagulation- Posterior to equator</li><li>➤ Cryotherapy- Anterior to equator</li><li>➤ Chemoreduction (Etoposide, Vincristine and Carboplatin)</li><li>➤ B Large tumors &gt;3 mm in dimension Any size tumors located &lt;3 mm from fovea, and &lt;1.5 mm from the optic disc margin Chemoreduction + focal consolidation Plaque radiotherapy</li><li>➤ Large tumors &gt;3 mm in dimension Any size tumors located &lt;3 mm from fovea, and &lt;1.5 mm from the optic disc margin</li><li>➤ Large tumors &gt;3 mm in dimension Any size tumors located &lt;3 mm from fovea, and &lt;1.5 mm from the optic disc margin</li><li>➤ Large tumors &gt;3 mm in dimension</li><li>➤ Any size tumors located &lt;3 mm from fovea, and &lt;1.5 mm from the optic disc margin</li><li>➤ Chemoreduction + focal consolidation Plaque radiotherapy</li><li>➤ Chemoreduction + focal consolidation Plaque radiotherapy</li><li>➤ Chemoreduction + focal consolidation</li><li>➤ Plaque radiotherapy</li><li>➤ C Subretinal seeds ≤ 3 mm from tumor Vitreous seeds ≤ 3 mm from tumor Both subretinal and vitreous seeds ≤ 3 mm from tumor Chemoreduction + focal consolidation Possible intravitreal chemotherapy for vitreous seeding</li><li>➤ Subretinal seeds ≤ 3 mm from tumor Vitreous seeds ≤ 3 mm from tumor Both subretinal and vitreous seeds ≤ 3 mm from tumor</li><li>➤ Subretinal seeds ≤ 3 mm from tumor Vitreous seeds ≤ 3 mm from tumor Both subretinal and vitreous seeds ≤ 3 mm from tumor</li><li>➤ Subretinal seeds ≤ 3 mm from tumor</li><li>➤ Vitreous seeds ≤ 3 mm from tumor</li><li>➤ Both subretinal and vitreous seeds ≤ 3 mm from tumor</li><li>➤ Chemoreduction + focal consolidation Possible intravitreal chemotherapy for vitreous seeding</li><li>➤ Chemoreduction + focal consolidation Possible intravitreal chemotherapy for vitreous seeding</li><li>➤ Chemoreduction + focal consolidation</li><li>➤ Possible intravitreal chemotherapy for vitreous seeding</li><li>➤ D Subretinal seeds &gt; 3 mm from tumor Vitreous seeds &gt; 3 mm from tumor Both subretinal and vitreous seeds &gt; 3 mm from retinoblastoma Chemoreduction + possible intravitreal chemotherapy External beam radiotherapy in some cases Enucleation, if poor response to other treatments</li><li>➤ Subretinal seeds &gt; 3 mm from tumor Vitreous seeds &gt; 3 mm from tumor Both subretinal and vitreous seeds &gt; 3 mm from retinoblastoma</li><li>➤ Subretinal seeds &gt; 3 mm from tumor Vitreous seeds &gt; 3 mm from tumor Both subretinal and vitreous seeds &gt; 3 mm from retinoblastoma</li><li>➤ Subretinal seeds &gt; 3 mm from tumor</li><li>➤ Vitreous seeds &gt; 3 mm from tumor</li><li>➤ Both subretinal and vitreous seeds &gt; 3 mm from retinoblastoma</li><li>➤ Chemoreduction + possible intravitreal chemotherapy External beam radiotherapy in some cases Enucleation, if poor response to other treatments</li><li>➤ Chemoreduction + possible intravitreal chemotherapy External beam radiotherapy in some cases Enucleation, if poor response to other treatments</li><li>➤ Chemoreduction + possible intravitreal chemotherapy</li><li>➤ External beam radiotherapy in some cases</li><li>➤ Enucleation, if poor response to other treatments</li><li>➤ E Extensive retinoblastoma occupying &gt; 50% of the globe with or without: Neovascular glaucoma Hemorrhage Extension of tumor to optic nerve or anterior chamber Enucleation Possible adjuvant chemotherapy if high-risk features</li><li>➤ Extensive retinoblastoma occupying &gt; 50% of the globe with or without: Neovascular glaucoma Hemorrhage Extension of tumor to optic nerve or anterior chamber</li><li>➤ Extensive retinoblastoma occupying &gt; 50% of the globe with or without:</li><li>➤ Neovascular glaucoma Hemorrhage Extension of tumor to optic nerve or anterior chamber</li><li>➤ Neovascular glaucoma</li><li>➤ Extension of tumor to optic nerve or anterior chamber</li><li>➤ Enucleation Possible adjuvant chemotherapy if high-risk features</li><li>➤ Enucleation Possible adjuvant chemotherapy if high-risk features</li><li>➤ Possible adjuvant chemotherapy if high-risk features</li></ul>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:608px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>ICRB Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>A</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Small <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> tumors (&lt;3mm)</li>\n<li>Located &gt;3 mm from the <span class=\"customMeta\" data-dictid=\"1d54a9ca8a16927772037b749264b0\">foveola</span> and &gt;1.5 mm from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Laser photocoagulation- <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">Posterior</span> to equator</strong></li>\n<li>Cryotherapy- <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> to equator</li>\n<li>Thermotherapy</li>\n<li>Chemoreduction (Etoposide, Vincristine and Carboplatin)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Large tumors &gt;3 mm in dimension</li>\n<li>Any size tumors located &lt;3 mm from fovea, and &lt;1.5 mm from the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc margin</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chemoreduction + <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> consolidation</li>\n<li>Plaque radiotherapy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>C</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Subretinal seeds ≤ 3 mm from tumor</li>\n<li>Vitreous seeds ≤ 3 mm from tumor</li>\n<li>Both <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> and <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> seeds ≤ 3 mm from tumor</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chemoreduction + <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> consolidation</li>\n<li>Possible <span class=\"customMeta\" data-dictid=\"67c9bce29d169277719036007848c0\">intravitreal</span> <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> for <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> seeding</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>D</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Subretinal seeds &gt; 3 mm from tumor</li>\n<li>Vitreous seeds &gt; 3 mm from tumor</li>\n<li>Both <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> and <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> seeds &gt; 3 mm from retinoblastoma</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Chemoreduction + possible <span class=\"customMeta\" data-dictid=\"67c9bce29d169277719036007848c0\">intravitreal</span> chemotherapy</li>\n<li>External beam <span class=\"customMeta\" data-dictid=\"a75f060aa1169277719777dd69df3f\">radiotherapy</span> in some cases</li>\n<li>Enucleation, if poor response to other treatments</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>E</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extensive <span class=\"customMeta\" data-dictid=\"fc941081ef16927771970c709f1103\">retinoblastoma</span> occupying &gt; 50% of the globe with or without:</p>\n<ul>\n<li>Neovascular glaucoma</li>\n<li>Hemorrhage</li>\n<li>Extension of tumor to <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve or <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Enucleation</strong></li>\n<li>Possible <span class=\"customMeta\" data-dictid=\"1a38e9a3321692777180b2468ff799\">adjuvant</span> <span class=\"customMeta\" data-dictid=\"8602c4b260169277718439bb122cb0\">chemotherapy</span> if high-risk features</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with vision problems and has a history of cataract surgery. OCT finding is shown below. What is the syndrome most likely associated with these findings?", "options": [{"label": "A", "text": "Posner-Schlossman Syndrome", "correct": false}, {"label": "B", "text": "Irvine-Gass Syndrome", "correct": true}, {"label": "C", "text": "Central Serous Retinopathy", "correct": false}, {"label": "D", "text": "Elschnig Pearls", "correct": false}], "correct_answer": "B. Irvine-Gass Syndrome", "question_images": ["https://image.prepladder.com/content/7Ot9ZQPwXx4E3MM2CYfI1741088058.png"], "explanation_images": ["https://image.prepladder.com/content/lYpGjzMJzJR40s8v8pOu1741088094.png", "https://image.prepladder.com/content/4p3RWJoZu7tHqhjxm0fU1741088112.png", "https://image.prepladder.com/content/ZxnuBLwUaqyv9hG1xAFB1741088166.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with a gradual loss of night vision and peripheral vision. What is the most likely diagnosis based on fundoscopy findings?", "options": [{"label": "A", "text": "Retinitis pigmentosa", "correct": true}, {"label": "B", "text": "Retinal hemorrhage", "correct": false}, {"label": "C", "text": "Diabetic retinopathy", "correct": false}, {"label": "D", "text": "Hypertensive retinopathy", "correct": false}], "correct_answer": "A. Retinitis pigmentosa", "question_images": ["https://image.prepladder.com/content/V9PfiPNqv9zUd321UY531724828556.png"], "explanation_images": ["https://image.prepladder.com/content/36gjTNFf0UKaq195QXpu1724828697.png"], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"4f1a033cae1692777197a3a6937a0c\"&gt;Retinitis&lt;/span&gt; pig\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A child presents with leukocoria and an intraocular mass. Microscopic examination reveals rosettes with scanty cytoplasm, and the mass is positive for synaptophysin and chromogranin. What is the diagnosis?", "options": [{"label": "A", "text": "Retinoblastoma", "correct": true}, {"label": "B", "text": "Medulloblastoma", "correct": false}, {"label": "C", "text": "Optic glioma", "correct": false}, {"label": "D", "text": "Choroidal melanoma", "correct": false}], "correct_answer": "A. Retinoblastoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/oBRXTKSEJ3pBtfFY1L7d1724831165.png"], "explanation": "<p>Correct Option A – R\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following criteria is not included in the definition of severe Non-Proliferative Diabetic Retinopathy (NPDR)?", "options": [{"label": "A", "text": "Microaneurysms in all quadrants", "correct": false}, {"label": "B", "text": "Retinal hemorrhage in all quadrants", "correct": false}, {"label": "C", "text": "Looping in all quadrants", "correct": true}, {"label": "D", "text": "Bleeding in two quadrants", "correct": false}], "correct_answer": "C. Looping in all quadrants", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:672px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Category </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">Retinopathy</span> (NPDR):</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>No <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in 12 months</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Very Mild NPDR</strong></p>\n<p>Microaneurysms only</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review most patients in 12 months</p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Mild NPDR </strong></p>\n<p>Any or all of the: microaneurysms, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages, exudates, and <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, up to the level of moderate NPDR. No <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> anomalies (IRMA) or significant beading.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review range 6-12 months, depending on the severity of signs, stability, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> factors, and patient's circumstances</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Moderate NPDR </strong></p>\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages in 1-3 quadrants or mild IRMA</li>\n<li>Significant <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> can be present in no more than 1 quadrant</li>\n<li>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots commonly present</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in approximately 6 months</p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Severe NPDR </strong></p>\n<p>The 4-2-1 rule; is one or more of the:</p>\n<ul>\n<li>Severe hemorrhages in all 4 quadrants <strong>(Option B ruled out)</strong></li>\n<li>Significant <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> in 2 or more quadrants <strong>(Option D ruled out)</strong></li>\n<li>Moderate IRMA in 1 or more quadrants <strong>(Option A ruled out)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in 4 months</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Very severe NPDR </strong></p>\n<p>Two or more of the criteria for severe NPDR</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Review in 2-3 months</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 72-year-old patient, with a history of cataract surgery and diabetes mellitus, presents with decreased vision one month after surgery. Examination reveals a honeycomb appearance or flower petal pattern of the retina. What is the likely diagnosis?", "options": [{"label": "A", "text": "Cystoid macular edema", "correct": true}, {"label": "B", "text": "Central serous retinopathy", "correct": false}, {"label": "C", "text": "Retinal detachment", "correct": false}, {"label": "D", "text": "Diabetic retinopathy", "correct": false}], "correct_answer": "A. Cystoid macular edema", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/0V7YP6edb96CqWvX9BVI1747311461.png", "https://image.prepladder.com/content/IdPHdu3CBdrQeJDF6FV81747311461.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient with rheumatoid arthritis who is noncompliant with treatment presents with complaints of superior field loss of vision for the past week. What is the most likely cause of this condition?", "options": [{"label": "A", "text": "Branched retinal artery occlusion", "correct": true}, {"label": "B", "text": "Central retinal artery occlusion", "correct": false}, {"label": "C", "text": "Branched retinal vein occlusion", "correct": false}, {"label": "D", "text": "Central retinal vein occlusion", "correct": false}], "correct_answer": "A. Branched retinal artery occlusion", "question_images": [], "explanation_images": [], "explanation": "<table>\n<thead>\n<tr>\n<th><strong>Type</strong></th>\n<th><strong>Subtypes</strong></th>\n<th><strong>Main Cause</strong></th>\n<th><strong>Key Clinical Feature</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td><strong>Arterial</strong></td>\n<td>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">Artery</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">Occlusion</span> (CRAO)</td>\n<td>Embolism (carotid or cardiac)</td>\n<td>Sudden, complete <span class=\"customMeta\" data-dictid=\"59d648a80c1692777192628f5db3c3\">monocular</span> blindness</td>\n</tr>\n<tr>\n<td> </td>\n<td>Branch <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">Artery</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">Occlusion</span> (BRAO)</td>\n<td>Embolism to a branch <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> artery</td>\n<td>Sudden, sectoral <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> loss</td>\n</tr>\n<tr>\n<td><strong>Venous</strong></td>\n<td>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">Vein</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">Occlusion</span> (CRVO)</td>\n<td>Hypertension, glaucoma, hyperviscosity</td>\n<td>Gradual or sudden blurring, \"blood and thunder\" fundus</td>\n</tr>\n<tr>\n<td> </td>\n<td>Branch <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">Vein</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">Occlusion</span> (BRVO)</td>\n<td>Hypertension, arteriosclerosis</td>\n<td>Sectoral hemorrhages, partial visual blurring</td>\n</tr>\n</tbody>\n</table>\n<table>\n<thead>\n<tr>\n<th><strong>Occlusion Type</strong></th>\n<th><strong>Pathogenesis</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td><strong>Artery</strong></td>\n<td>Embolic or thrombotic <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> → <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">ischemia</span> → inner <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> layer damage</td>\n</tr>\n<tr>\n<td><strong>Vein</strong></td>\n<td>Venous <span class=\"customMeta\" data-dictid=\"ea73ce564216927771989ea1aa2c3d\">stasis</span> + increased backpressure → hemorrhage, <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, ischemia</td>\n</tr>\n</tbody>\n</table>\n<table>\n<thead>\n<tr>\n<th><strong>Condition</strong></th>\n<th><strong>Fundus Appearance</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td><strong>CRAO</strong></td>\n<td>Pale retina, <span class=\"customMeta\" data-dictid=\"1010368fae169277718497ba557426\">cherry-red spot</span> at macula</td>\n</tr>\n<tr>\n<td><strong>BRAO</strong></td>\n<td>Localized pale <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> corresponding to affected artery</td>\n</tr>\n<tr>\n<td><strong>CRVO</strong></td>\n<td>Diffuse <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages, dilated <span class=\"customMeta\" data-dictid=\"4632fe89141692777200f671693e55\">tortuous</span> veins, <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc edema</td>\n</tr>\n<tr>\n<td><strong>BRVO</strong></td>\n<td>Hemorrhages limited to one <span class=\"customMeta\" data-dictid=\"3a757d7c1216927771968223be411d\">quadrant</span> or sector of retina</td>\n</tr>\n</tbody>\n</table>\n<table>\n<thead>\n<tr>\n<th><strong>Systemic</strong></th>\n<th><strong>Ocular</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>Hypertension</td>\n<td>Glaucoma</td>\n</tr>\n<tr>\n<td>Diabetes mellitus</td>\n<td>Optic disc crowding</td>\n</tr>\n<tr>\n<td>Atherosclerosis</td>\n<td>Increased IOP</td>\n</tr>\n<tr>\n<td>Rheumatic heart disease</td>\n<td>Retinal <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> anomalies</td>\n</tr>\n<tr>\n<td>Hypercoagulable states</td>\n<td>—</td>\n</tr>\n</tbody>\n</table>\n<table>\n<thead>\n<tr>\n<th><strong>Condition</strong></th>\n<th><strong>Visual Field</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td>CRAO</td>\n<td>Total field loss</td>\n</tr>\n<tr>\n<td>BRAO</td>\n<td>Quadrantic or sectoral loss (e.g., superior field loss = <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> BRAO)</td>\n</tr>\n<tr>\n<td>CRVO</td>\n<td>Diffuse loss or central blurring</td>\n</tr>\n<tr>\n<td>BRVO</td>\n<td>Sectoral field defect</td>\n</tr>\n</tbody>\n</table>\n<table>\n<thead>\n<tr>\n<th><strong>Condition</strong></th>\n<th><strong>Management</strong></th>\n</tr>\n</thead>\n<tbody>\n<tr>\n<td><strong>CRAO</strong></td>\n<td>Ocular massage, reduce IOP, <span class=\"customMeta\" data-dictid=\"1b1cc7f2861692777189c9bd7d9b81\">hyperbaric</span> O2, treat cause (e.g., embolus)</td>\n</tr>\n<tr>\n<td><strong>BRAO</strong></td>\n<td>Often irreversible; investigate <span class=\"customMeta\" data-dictid=\"acd7af7f74169277718736b038fb02\">embolic</span> source (heart, carotid)</td>\n</tr>\n<tr>\n<td><strong>CRVO/BRVO</strong></td>\n<td>Control risk factors, anti-VEGF injections, <span class=\"customMeta\" data-dictid=\"440df3f37a16927771883b385ce82d\">grid</span> laser (for <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema), PRP (for neovascularization)</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 22-year-old patient with high myopia and thick glasses presents with floaters in his eyes. What is the likely cause of this condition?", "options": [{"label": "A", "text": "Subarachnoid hemorrhage", "correct": false}, {"label": "B", "text": "Retinal detachment", "correct": true}, {"label": "C", "text": "Vitreous hemorrhage", "correct": false}, {"label": "D", "text": "Branched retinal artery occlusion", "correct": false}], "correct_answer": "B. Retinal detachment", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\"&gt;Retinal&lt;/span&gt; detach\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the cause of sudden painless loss of vision?", "options": [{"label": "A", "text": "Chemical injuries to the eyeball", "correct": false}, {"label": "B", "text": "Acute congestive glaucoma", "correct": false}, {"label": "C", "text": "Acute iridocyclitis", "correct": false}, {"label": "D", "text": "Central serous retinopathy", "correct": true}], "correct_answer": "D. Central serous retinopathy", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/kVoIBHFFjV7lQSJelzvY1747218691.png", "https://image.prepladder.com/content/5DoGknUNTqjha52OUnYp1747218700.png", "https://image.prepladder.com/content/tGFLRAFweBNAWLqYDEyP1747218710.png", "https://image.prepladder.com/content/6GGj0gioUar4CWcsmKuU1747218723.png", "https://image.prepladder.com/content/JT7uYAcCLEg9UMfixslW1747218740.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions is associated with the curtain falling sign?", "options": [{"label": "A", "text": "Retinal detachment", "correct": true}, {"label": "B", "text": "Macular degeneration", "correct": false}, {"label": "C", "text": "Optic atrophy", "correct": false}, {"label": "D", "text": "Acute anterior uveitis", "correct": false}], "correct_answer": "A. Retinal detachment", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/sdUvy10nqjS81sIkHTAe1747219467.png", "https://image.prepladder.com/content/xun1AuKyumQr79ogjNCM1747378890.png", "https://image.prepladder.com/content/4uZQp3gX4XvL4VgL7e5b1747378841.png", "https://image.prepladder.com/content/U4Yk2cEk9LHwy1MAqmQz1747219498.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Type of <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Clinical Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rhegmatogenous <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Floaters </strong>(dark spots) due to rapid <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> degeneration.</li>\n<li><strong>Photopsia </strong>(flashes of light) caused by <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"3a74ed0fcf16927771901a79847565\">irritation</span> from <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> movements.</li>\n<li>Gradual <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> loss, initially localized, progressing to total vision loss as <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> spreads.</li>\n<li><strong>Dark veil/Curtain falling sign/cloud in front of the eye</strong>, particularly when <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> reaches the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> region.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NYC Wanderer (Kevin Eng) \" data-hash=\"\" data-license=\"CC BY-SA 2.0\" data-source=\"https://en.wikipedia.org/wiki/Book#/media/File:Gutenberg_Bible,_Lenox_Copy,_New_York_Public_Library,_2009._Pic_01.jpg\" data-tags=\"\" height=\"255\" src=\"https://image.prepladder.com/content/sdUvy10nqjS81sIkHTAe1747219467.png\" width=\"367\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Sudden, painless vision loss in large, central detachment. </strong></li>\n<li>Retinal breaks may be round, horseshoe-shaped, slit-like, or large <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> dialysis.</li>\n</ul>\n<figure class=\"caption_element\"><img alt=\"\" data-author=\"Jesse Vislisel, MD\" data-hash=\"\" data-license=\"CC BY NC ND 3.0\" data-source=\"https://eyerounds.org/atlas/pages/rhegmatogenous-ret-detach.htm#gsc.tab=0\" data-tags=\"\" height=\"357\" src=\"https://image.prepladder.com/content/xun1AuKyumQr79ogjNCM1747378890.png\" width=\"500\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n<ul>\n<li>Vitreous pigments (tobacco dusting or <strong>Shaffer sign</strong>) are seen in the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> detachment.</li>\n<li>Old <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> shows <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> thinning, <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> <span class=\"customMeta\" data-dictid=\"6e26f8de1c1692777185d8f3885a0c\">demarcation</span> lines (high water marks), and secondary <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> cysts.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Gradual, progressive visual loss</li>\n<li>Typically painless</li>\n<li>No associated flashes or floaters</li>\n<li><strong>Vitreoretinal bands present</strong></li>\n<li>No <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> breaks</li>\n<li>Detached area - <span class=\"customMeta\" data-dictid=\"9b5c0ed1601692777184e597f453c9\">concave</span> and localized</li>\n<li>No shifting fluid</li>\n</ul>\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"500\" src=\"https://image.prepladder.com/content/4uZQp3gX4XvL4VgL7e5b1747378841.png\" width=\"500\"/></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exudative <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Detachment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Painless and sudden or gradual visual loss</li>\n<li>No photopsia, holes/ tears, folds and undulations.</li>\n<li>Smooth and <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> with <span class=\"customMeta\" data-dictid=\"45d1f54a631692777195670b446c7e\">pigmentary</span> disturbances</li>\n<li>Rounded and fixed with <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> on the tumor summit.</li>\n<li><strong>Shifting fluid </strong>- changing the position of the detached area with gravity - hallmark feature.</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author='\"Henry Zou Lauren Fletcher-Morehouse\"' data-hash=\"\" data-license=\"CC BY 3.0\" data-source=\"https://www.researchgate.net/figure/Exudative-retinal-detachment-ERD-of-both-eyes-at-one-week-post-op_fig1_362643260\" data-tags=\"\" height=\"377\" src=\"https://image.prepladder.com/content/U4Yk2cEk9LHwy1MAqmQz1747219498.png\" width=\"377\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is incorrect about Retinitis pigmentosa?", "options": [{"label": "A", "text": "ERG show decreased amplitude of a and b wave", "correct": false}, {"label": "B", "text": "Rod dystrophy &amp;gt; Cone dystrophy", "correct": false}, {"label": "C", "text": "Late presentation is loss of peripheral vision", "correct": false}, {"label": "D", "text": "Night vision is lost late and rare", "correct": true}], "correct_answer": "D. Night vision is lost late and rare", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"3a81134c8a16927771936151d6b34e\"&gt;Night vision&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male patient presents to the ophthalmology clinic with complaints of visual disturbances. He reports that he is unable to see on the left side from the left eye and the left side from his right eye. However, he notices that his central vision remains intact and unaffected. The patient denies any recent trauma or other significant medical history. What is the most likely visual deficit that the patient is experiencing?", "options": [{"label": "A", "text": "Quadrantanopia", "correct": false}, {"label": "B", "text": "Heteronymous hemianopia", "correct": false}, {"label": "C", "text": "Homonymous hemianopia", "correct": false}, {"label": "D", "text": "Homonymous hemianopia with macular sparing", "correct": true}], "correct_answer": "D. Homonymous hemianopia with macular sparing", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"0600a6b52316927771899e12e7ec86\"&gt;Homonymous&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"64341b503a1692777188b9a3b26c59\"&gt;hemianopia&lt;/span&gt; with &lt;span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\"&gt;macular&lt;/span&gt; sparing\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 55-year-old male patient presents to the clinic with a complaint of sudden visual blurring that lasted for a short duration . He reports that during the episode, he completely lost vision in his left eye for a few minutes and then regained his vision . The patient denies any pain, headache, or other associated symptoms during the episode. What is the most likely diagnosis ?", "options": [{"label": "A", "text": "Amaurosis fugax", "correct": true}, {"label": "B", "text": "Central retinal artery occlusion", "correct": false}, {"label": "C", "text": "Central retinal vein occlusion", "correct": false}, {"label": "D", "text": "Hypertensive retinopathy", "correct": false}], "correct_answer": "A. Amaurosis fugax", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"2d543b30f11692777181065432d64e\"&gt;Amaurosis&lt;/span&gt; Fug\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the marked layer of the retina", "options": [{"label": "A", "text": "Inner plexiform layer", "correct": true}, {"label": "B", "text": "Ganglion cell layer", "correct": false}, {"label": "C", "text": "Inner nuclear layer", "correct": false}, {"label": "D", "text": "Outer plexiform layer", "correct": false}], "correct_answer": "A. Inner plexiform layer", "question_images": ["https://image.prepladder.com/content/gHcQa4dTLyUxFORBYxOY1716192961.png"], "explanation_images": ["https://image.prepladder.com/content/6K8d9F6l7VcM3R7KvGV91716202008.png"], "explanation": "<p>Correct Option A - Inner &lt;span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\"&gt;plexiform&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the lesion in the histopathological image of retina.", "options": [{"label": "A", "text": "Drusen", "correct": true}, {"label": "B", "text": "Hard exudates", "correct": false}, {"label": "C", "text": "Cotton wool spots", "correct": false}, {"label": "D", "text": "Microaneurysms", "correct": false}], "correct_answer": "A. Drusen", "question_images": ["https://image.prepladder.com/content/k6Zlvutbc9oN88XxR67N1715674744.png"], "explanation_images": [], "explanation": "<p>Correct Option A - Dru\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What could be the likely diagnosis for a 65-year-old female patient with a prior diagnosis of chronic arthritis, undergoing treatment, who presents with complaints of impaired vision in both eyes and fundus angiography depicted the following finding?", "options": [{"label": "A", "text": "Choroiditis", "correct": false}, {"label": "B", "text": "Chloroquine toxicity", "correct": true}, {"label": "C", "text": "Steroid – induced glaucoma", "correct": false}, {"label": "D", "text": "Macular edema", "correct": false}], "correct_answer": "B. Chloroquine toxicity", "question_images": ["https://image.prepladder.com/content/miABupmbXd6qWjninXRj1715237565.png"], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"65d6c8e3de1692777184e31e936d9f\"&gt;Chloroquine&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The image is suggestive of?", "options": [{"label": "A", "text": "Macular hole", "correct": false}, {"label": "B", "text": "Cystoid macular edema", "correct": true}, {"label": "C", "text": "Central serous chorioretinopathy", "correct": false}, {"label": "D", "text": "Age related Macular degeneration", "correct": false}], "correct_answer": "B. Cystoid macular edema", "question_images": ["https://image.prepladder.com/content/qoeLRCMn7UICeQ1c9nPe1715237760.png"], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\"&gt;Cystoid&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\"&gt;macular&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "At what point would you suggest conducting a dilated fundus examination for a person diagnosed with diabetes on their 45 th birthday?", "options": [{"label": "A", "text": "Immediately", "correct": true}, {"label": "B", "text": "Before his 50th birthday", "correct": false}, {"label": "C", "text": "After his 50th birthday", "correct": false}, {"label": "D", "text": "When the complains of decrease in vision", "correct": false}], "correct_answer": "A. Immediately", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - I\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "To confirm the diagnosis, what additional investigation should be conducted for a child exhibiting symptoms of night blindness and delayed dark adaptation?", "options": [{"label": "A", "text": "Dark adaptometry", "correct": false}, {"label": "B", "text": "ERG", "correct": true}, {"label": "C", "text": "EOG", "correct": false}, {"label": "D", "text": "Retinoscopy", "correct": false}], "correct_answer": "B. ERG", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - ERG\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is true regarding retinoscopy using a plane mirror?", "options": [{"label": "A", "text": "In hypermetropia the red glow moves in opposite direction", "correct": false}, {"label": "B", "text": "In myopia the red glow moves in same direction", "correct": false}, {"label": "C", "text": "In emmetropia the red glow moves in opposite direction", "correct": false}, {"label": "D", "text": "Done at 1 meter away from patient", "correct": true}], "correct_answer": "D. Done at 1 meter away from patient", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - D\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Roth spots are seen in ____________.", "options": [{"label": "A", "text": "Acute leukemia", "correct": true}, {"label": "B", "text": "Uveitis", "correct": false}, {"label": "C", "text": "Optic neuritis", "correct": false}, {"label": "D", "text": "Vogt-Koyanagi-Harada syndrome", "correct": false}], "correct_answer": "A. Acute leukemia", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/44CT6rl9WtU9W2zzkceu1715162259.png", "https://image.prepladder.com/content/Hl9Lpe1UAih9Sa3zoOxJ1715158312.png"], "explanation": "<p>Correct Option A - &lt;span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\"&gt;Acute&lt;/span&gt; leuk\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the commonly used chemotherapy regimen for the treatment of retinoblastoma?", "options": [{"label": "A", "text": "Vinblastine, etoposide and bleomycin", "correct": false}, {"label": "B", "text": "Vinblastine, vincristine and etoposide", "correct": false}, {"label": "C", "text": "Vinblastine, vincristine and cisplatin", "correct": false}, {"label": "D", "text": "Vincristine, carboplatin and etoposide", "correct": true}], "correct_answer": "D. Vincristine, carboplatin and etoposide", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Vincristine, carboplatin,\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not true about retinitis pigmentosa?", "options": [{"label": "A", "text": "Retinal pigmentation", "correct": false}, {"label": "B", "text": "Pale waxy disc", "correct": false}, {"label": "C", "text": "Narrowing of vessels", "correct": false}, {"label": "D", "text": "ERG – normal", "correct": true}], "correct_answer": "D. ERG – normal", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"2a080283331692777187f1a881e3d1\"&gt;ERG&lt;/span&g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions is associated with retinitis pigmentosa?", "options": [{"label": "A", "text": "Arteriolar attenuation", "correct": true}, {"label": "B", "text": "Neovascularization", "correct": false}, {"label": "C", "text": "Retinal artery thrombosis", "correct": false}, {"label": "D", "text": "Papilledema", "correct": false}], "correct_answer": "A. Arteriolar attenuation", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/gmgmLKeEcJLY63yCA25f1715237491.png"], "explanation": "<p>Correct Option A - Arteriolar attenu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What would be the diagnosis for a diabetic patient experiencing an abrupt vision loss, having a visual acuity of 6/60, with a fundus picture provided?", "options": [{"label": "A", "text": "CRVO", "correct": false}, {"label": "B", "text": "CRAO", "correct": true}, {"label": "C", "text": "Diabetic retinopathy", "correct": false}, {"label": "D", "text": "Hypertensive retinopathy", "correct": false}], "correct_answer": "B. CRAO", "question_images": ["https://image.prepladder.com/content/odpQBr2yJ71fpqrbWAhW1695204130.png"], "explanation_images": [], "explanation": "<p>Correct Option B - CRAO: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Please identify the structure indicated by the arrow.", "options": [{"label": "A", "text": "Outer limiting membrane", "correct": false}, {"label": "B", "text": "Inner plexiform layer", "correct": false}, {"label": "C", "text": "Choroid", "correct": true}, {"label": "D", "text": "Outer nuclear layer", "correct": false}], "correct_answer": "C. Choroid", "question_images": ["https://image.prepladder.com/content/N9X7TrWRmxakEBenwBSw1715237344.png"], "explanation_images": [], "explanation": "<p>Correct Option C - Ch\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "ETDRS study was related to", "options": [{"label": "A", "text": "Central retinal artery occlusion", "correct": false}, {"label": "B", "text": "Diabetic macular edema", "correct": true}, {"label": "C", "text": "Primary open angle glaucoma", "correct": false}, {"label": "D", "text": "Non – infectious uveitis", "correct": false}], "correct_answer": "B. Diabetic macular edema", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - &lt;span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\"&gt;Diabetic&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\"&gt;macular&lt;/span&g\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 61-year-old university professor complains of vision loss in his left eye. He compares the sensation to a curtain being pulled over his affected eye. Additionally, he experienced flashing lights and floaters a week ago. The provided image shows a B-scan of his left eye. What could be the possible diagnosis for his condition?", "options": [{"label": "A", "text": "Glaucoma", "correct": false}, {"label": "B", "text": "Posterior vitreous detachment", "correct": false}, {"label": "C", "text": "Retinal detachment", "correct": true}, {"label": "D", "text": "Corneal ulcer", "correct": false}], "correct_answer": "C. Retinal detachment", "question_images": ["https://image.prepladder.com/content/d1UMtpWoNPKlDpjjqhcs1715257569.JPG"], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\"&gt;Retinal&lt;/span&gt; detach\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the most probable diagnosis for a 3-year-old boy who has been displaying increased clumsiness for the past 6 months, and upon examination, a cauliflower-like growth, leukocoria, and an absent red reflex in the left eye? Enucleation was performed, and microscopic examination of the specimen reveals the presence of Flexner-Wintersteiner rosettes.", "options": [{"label": "A", "text": "Retinoblastoma", "correct": true}, {"label": "B", "text": "Neurofibroma", "correct": false}, {"label": "C", "text": "Retinopathy of prematurity", "correct": false}, {"label": "D", "text": "Toxcariasis", "correct": false}], "correct_answer": "A. Retinoblastoma", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/sRBjnRWU9PuTO9UHd7Fk1715163701.png"], "explanation": "<p>Correct Option A - R\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 61 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Fundus examination reveals multiple white retinal patches near the optic disc, cotton wool spots, and minimal intraretinal hemorrhage. Based on these findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Diabetic Retinopathy", "correct": false}, {"label": "B", "text": "Retinal Vein Occlusion", "correct": false}, {"label": "C", "text": "Purtscher Retinopathy", "correct": true}, {"label": "D", "text": "Central Serous Retinopathy", "correct": false}], "correct_answer": "C. Purtscher Retinopathy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/OC8SbBpvCwtko45ubSyK1743694774.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Trauma (head, chest), fractures, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> diseases like SLE, pancreatitis, pre-eclampsia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fundoscopy features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Purtscher Flecken:</strong> White patches near the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc and <span class=\"customMeta\" data-dictid=\"82c2ec751816927772034d164bf755\">fovea</span> due to arteriolar occlusion.</li>\n<li><strong>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">Wool</span> Spots: </strong>Infarcts in the nerve fiber layer, typically restricted to the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole.</li>\n<li><strong>Retinal Hemorrhages: </strong>Small, low-to-moderate hemorrhages.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnostic Criteria</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Requires 3 out of 5:</strong></p>\n<ul>\n<li>Purtscher flecken</li>\n<li>Hemorrhages</li>\n<li>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots</li>\n<li>Plausible cause</li>\n<li>Investigation <span class=\"customMeta\" data-dictid=\"8baf7b24c316927771847e2b2ae466\">compatible</span> with the diagnosis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ocular investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Fundus <span class=\"customMeta\" data-dictid=\"468accc4d3169277720252132f5b85\">Fluorescein</span> <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">Angiography</span> (FFA):</strong> Reveals <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> ischemia, <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion, and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve head leakage.</li>\n<li><strong>Optical Coherence <span class=\"customMeta\" data-dictid=\"8d4f2a375b1692777200f41db641bc\">Tomography</span> (OCT):</strong> Demonstrates <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> thickening, <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> fluid, and <span class=\"customMeta\" data-dictid=\"61b0f28598169277719523480b9ee4\">photoreceptor</span> loss in later stages.</li>\n<li><strong>OCT Angiography:</strong> Can show <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> ischemia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Supportive care, steroids, anti-VEGF for <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ABxFUBKvqOGJetmKXU6Z1746118799.mp3", "video": ""}, {"text": "A 30-week premature infant weighing 1.4 kg is diagnosed with stage 3 retinopathy of prematurity (ROP) in zone II without plus disease. What is the most appropriate next step in management?", "options": [{"label": "A", "text": "Laser photocoagulation", "correct": false}, {"label": "B", "text": "Intravitreal anti-VEGF injection", "correct": false}, {"label": "C", "text": "Weekly observation and follow-up", "correct": true}, {"label": "D", "text": "Cryotherapy of retina", "correct": false}], "correct_answer": "C. Weekly observation and follow-up", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zone I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bounded by a circle, the <span class=\"customMeta\" data-dictid=\"ec7c10c0421692777197d151a4c0b5\">radius</span> of which is twice the distance between the center of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc and center of the macula.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zone II</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extends from the edge of the zone 1 peripherally to a point tangential to the <span class=\"customMeta\" data-dictid=\"31c5d0e75f16927771938d8e2daa4c\">nasal</span> <span class=\"customMeta\" data-dictid=\"4ddf5d11d71692777194fac8ecc625\">ora</span> serrata.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Zone III</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Consists of <span class=\"customMeta\" data-dictid=\"a459f313d9169277719789fdfb7ada\">residual</span> <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> <span class=\"customMeta\" data-dictid=\"0539eefe3f169277718547881d187d\">crescent</span> of <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> to zone II.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type II</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>High-Risk Prethreshold Disease</strong>, requiring laser photocoagulation.</p>\n<ul>\n<li><strong>Zone I: </strong>Plus disease, any stage.</li>\n<li><strong>Zone I: </strong>Non-plus disease, stage 3.</li>\n<li><strong>Zone II: </strong>Plus disease, stages 2 and 3. <strong>(Option A)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Low-Risk Prethreshold Disease</strong>, requiring weekly follow-up.</p>\n<ul>\n<li><strong>Zone I: </strong>Non-plus disease, stages 1 and 2.</li>\n<li><strong>Zone II: </strong>Non-plus disease, stage 3.<strong> (Option C)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/LtAa9jpECBJJKwwVIQHu1746118563.mp3", "video": ""}, {"text": "A 65-year-old male presents to the emergency department with sudden, painless vision loss in his right eye. On examination, the right eye shows a pale retina with a cherry-red spot at the macula. The patient has a history of hypertension and smoking. Which of the following is the most appropriate initial treatment to improve retinal blood flow and potentially restore vision?", "options": [{"label": "A", "text": "Oral corticosteroids", "correct": false}, {"label": "B", "text": "Intravitreal anti-VEGF injection", "correct": false}, {"label": "C", "text": "Ocular massage and anterior chamber paracentesis", "correct": true}, {"label": "D", "text": "Systemic anticoagulation therapy", "correct": false}], "correct_answer": "C. Ocular massage and anterior chamber paracentesis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Goals</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Restore Blood Flow</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Dislodge or break down the <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">blockage</span> in the central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> as quickly as possible.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimize <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Damage</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limit the duration of <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">ischemia</span> to reduce permanent damage to <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> tissue.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Address Underlying Conditions</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Identify and manage underlying conditions like atherosclerosis, hypertension, and <span class=\"customMeta\" data-dictid=\"e1fb96fd2416927771830dfed40e14\">cardiac</span> diseases.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment Options</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ocular <span class=\"customMeta\" data-dictid=\"c515f6a71d16927771919f574f1ee9\">Massage</span> (within 24 hrs)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Apply pressure to the globe to dislodge the embolus; performed using a three-mirror contact lens.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior Chamber Paracentesis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Withdraw <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor to decrease <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure, potentially dislodging the embolus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medications to Lower IOP</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Topical Apraclonidine &amp; Timolol</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduce <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor production to lower IOP</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intravenous Acetazolamide<strong> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Provides<strong> </strong><strong>sustained <span class=\"customMeta\" data-dictid=\"44317409bb16927771907e9af17a8b\">IOP</span> reduction</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vasodilators</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sublingual <strong>Isosorbide Dinitrate</strong> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Dilates blood vessels </strong>to improve <span class=\"customMeta\" data-dictid=\"82cc227a1c169277718387905b50c6\">blood flow</span> past the blockage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Carbon <span class=\"customMeta\" data-dictid=\"0bd01a042116927771868e3482910e\">Dioxide</span> Inhalation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>\"Rebreathing\" into a Paper Bag</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases <span class=\"customMeta\" data-dictid=\"c32b3a9fac16927771831530888fdf\">carbon dioxide</span> levels to induce vasodilation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carbogen Breathing</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Controlled <span class=\"customMeta\" data-dictid=\"0b1500fcd816927771900b59d16bde\">inhalation</span> of high oxygen (95%) and <span class=\"customMeta\" data-dictid=\"c32b3a9fac16927771831530888fdf\">carbon dioxide</span> (5%) mixtures to induce <span class=\"customMeta\" data-dictid=\"7aa9f8d34616927772018c11493bbc\">vasodilation</span> and slow down ischemia.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hyperosmotic agents </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mannitol or <span class=\"customMeta\" data-dictid=\"124462cc291692777188e1a9cce583\">glycerol</span> <strong>(Option A&amp;B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rapid IOP-lowering</strong> effect and raised <span class=\"customMeta\" data-dictid=\"837d6227d81692777190a063ea2cd4\">intravascular</span> volume</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Transluminal <span class=\"customMeta\" data-dictid=\"61b85c92571692777193ac7a5a5c48\">Nd:YAG</span> laser embolysis/embolectomy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>For BRAO and CRAO where an occluding <span class=\"customMeta\" data-dictid=\"cd7b88eaf5169277718749baf505bd\">embolus</span> is visible; Good final visual results achieved</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Thrombolysis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Local <span class=\"customMeta\" data-dictid=\"c7c5b5c17a16927771905ab1f7f8c2\">Intra-arterial</span> or Intravenous</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Directly dissolve clots with <span class=\"customMeta\" data-dictid=\"78e1197ee31692777200fa8819cf74\">thrombolytic</span> agents; <span class=\"customMeta\" data-dictid=\"7f80be61231692777187391e91e867\">efficacy</span> in CRAO is inconclusive.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Local <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">Intraocular</span> Thrombolysis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Use of rtPA for thrombolysis; large trials show no significant benefit</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Systemic Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Urgent Referral</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Immediate evaluation by a stroke specialist due to high stroke risk.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management of Risk Factors</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Smoking Cessation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Reduce overall <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> risk.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cardiac <span class=\"customMeta\" data-dictid=\"5280ec6ae91692777182aa6322ae68\">Arrhythmia</span> Management</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Refer to a physician for conditions like atrial fibrillation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Antiplatelet Therapy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>To reduce further <span class=\"customMeta\" data-dictid=\"40d68b98721692777183c42090e023\">blood clot</span> formation, unless contraindicated.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oral Anticoagulation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Warfarin or other anticoagulants for conditions like atrial fibrillation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Carotid Endarterectomy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Considered for significant <span class=\"customMeta\" data-dictid=\"8593e48e0416927771834eaedb0bfd\">carotid</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> stenosis.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/rS9MOLtkOfBdPvXftIdE1746099875.mp3", "video": ""}, {"text": "A 58-year-old male with a 20-year history of poorly controlled type 2 diabetes and an HbA1c of 10.5% came for an ophthalmic examination. Fundoscopy reveals microaneurysms, hard exudates, and retinal thickening. Which of the following is the most likely cause of future vision loss in this patient?", "options": [{"label": "A", "text": "Vitreous hemorrhage", "correct": false}, {"label": "B", "text": "Retinal detachment", "correct": false}, {"label": "C", "text": "Macular edema", "correct": true}, {"label": "D", "text": "Neovascular glaucoma", "correct": false}], "correct_answer": "C. Macular edema", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/sKhvkDwBLn4lThzM4RGx1743689248.png", "https://image.prepladder.com/notes/av7Ec8FONNsUANGAAfgY1743689386.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gm2dL5CbnEqmtgeViUS21746087494.mp3", "video": ""}, {"text": "A 64-year-old male with long-standing hypertension comes for a routine eye checkup. On fundoscopy, the ophthalmologist observes the following changes as shown in the image below. What is the most likely stage of hypertensive retinopathy?", "options": [{"label": "A", "text": "Grade I", "correct": false}, {"label": "B", "text": "Grade II", "correct": false}, {"label": "C", "text": "Grade III", "correct": true}, {"label": "D", "text": "Grade IV", "correct": false}], "correct_answer": "C. Grade III", "question_images": ["https://image.prepladder.com/notes/9uJALdddWB5ZS44Q4p3X1746183698.png"], "explanation_images": ["https://image.prepladder.com/notes/U3MJb3JGP6NWYWKN33Nd1746092674.png", "https://image.prepladder.com/notes/m9SuT9ezHO2Vl85ulXgn1743692897.png", "https://image.prepladder.com/notes/33K0WF8wQARSHnWVD53s1746093796.png", "https://image.prepladder.com/notes/mLHn7E1wlB3D4cbc4jpe1743692943.png", "https://image.prepladder.com/notes/dMAz96OFJaZvpr7brLOh1746092792.png", "https://image.prepladder.com/notes/odC51STzhLKzR18Twrya1746092855.png", "https://image.prepladder.com/notes/9uJALdddWB5ZS44Q4p3X1746183698.png", "https://image.prepladder.com/notes/RJz4p1zOdXyRy0trp6SQ1746092911.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Stage</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade I </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild generalized arteriolar narrowing, broadening of the light reflex.<br/>\n\t\t\t </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Grade I \" data-author=\"Frank Wood \" data-hash=\"11474\" data-license=\"CC BY 3.0\" data-source=\"https://en.wikipedia.org/wiki/Hypertensive_retinopathy#/media/File:Hypertensiveretinopathy.jpg\" data-tags=\"May2025\" height=\"252\" src=\"https://image.prepladder.com/notes/dMAz96OFJaZvpr7brLOh1746092792.png\" width=\"252\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade II </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Focal arteriolar narrowing, A-V <span class=\"customMeta\" data-dictid=\"35a03747441692777193ad0853e2d9\">nicking</span> (Salu’s sign)</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Grade II \" data-author=\"Kalyan Koushik Atakapuram, Ram Das P\" data-hash=\"11475\" data-license=\"CC BY-SA NC 4.0\" data-source=\"https://www.researchgate.net/figure/Fundus-picture-of-right-eye-showing-Grade-2-hypertensive-retinopathy-changes-with_fig4_372031680\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/odC51STzhLKzR18Twrya1746092855.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade III </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flame-shaped hemorrhages, cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots, and more pronounced A-V <span class=\"customMeta\" data-dictid=\"35a03747441692777193ad0853e2d9\">nicking</span> (Bonnet and Gunn signs), hemorrhages, and exudates.</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"Stage 3 hypertensive retinopathy\" data-author=\"Macarie Sorin Simion, Kadar Alexandra\" data-hash=\"11543\" data-license=\"NA\" data-source=\"https://rjo.ro/wp-content/uploads/2020/04/RJO_iss1_2020.pdf\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/9uJALdddWB5ZS44Q4p3X1746183698.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Grade IV </strong><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>All features of Grade III + Papilledema, Silver-wiring of arterioles.<br/>\n\t\t\t </p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"grade 4\" data-author=\"Kalyan Koushik Atakapuram, Ram Das P\" data-hash=\"11476\" data-license=\"CC BY-SA NC 4.0\" data-source=\"https://www.researchgate.net/figure/Fundus-picture-of-right-eye-showing-Grade-4-hypertensive-retinopathy-changes-with-Disc_fig1_372031680\" data-tags=\"May2025\" src=\"https://image.prepladder.com/notes/RJz4p1zOdXyRy0trp6SQ1746092911.png\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UBjspoboWDsDWtlhNZxt1746119483.mp3", "video": ""}, {"text": "A 45-year-old male presents with complaints of severe headache and blurred vision. His blood pressure is 220/120 mmHg. Fundoscopy image is given below. Which of the following fundus changes is most characteristic of this diagnosis?", "options": [{"label": "A", "text": "Arteriovenous nicking", "correct": false}, {"label": "B", "text": "Copper-wiring", "correct": false}, {"label": "C", "text": "Papilledema", "correct": true}, {"label": "D", "text": "Hard exudates", "correct": false}], "correct_answer": "C. Papilledema", "question_images": ["https://image.prepladder.com/notes/PqukUWfGSPYcAP5pj2K21743693341.png"], "explanation_images": ["https://image.prepladder.com/notes/dSXrYDjsSDGrQQ44QYPF1743693394.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Finding</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Papilledema</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Swelling of <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc due to raised <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve ischemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exudates</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lipid deposits; may <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> a <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> star</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retinal hemorrhages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Flame-shaped hemorrhages, especially in <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ischemic infarcts of nerve fiber layer</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Venous dilation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Result of <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> congestion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Narrowing of arterioles</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe <span class=\"customMeta\" data-dictid=\"88758385011692777201c7fff08b99\">vasospasm</span> in <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> cases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Elschnig’s spots</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Black spots with yellow halos from <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> infarcts</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Siegrist’s streaks</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Linear <span class=\"customMeta\" data-dictid=\"b5f46d7e431692777195efd6b43e9f\">pigmentation</span> along <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> arterioles from <span class=\"customMeta\" data-dictid=\"43b1f01822169277720222a3b354dd\">fibrinoid</span> necrosis</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Chronic <span class=\"customMeta\" data-dictid=\"dd2daa0c6216927771893c9cab82d9\">Hypertensive</span> Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Malignant <span class=\"customMeta\" data-dictid=\"dd2daa0c6216927771893c9cab82d9\">Hypertensive</span> Retinopathy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Arteriolar narrowing</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Generalized or <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> narrowing, <span class=\"customMeta\" data-dictid=\"c270267d20169277718081ecee6362\">A-V</span> <span class=\"customMeta\" data-dictid=\"35a03747441692777193ad0853e2d9\">nicking</span> <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marked narrowing due to vasospasm</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retinal <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">reflex</span> changes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Copper-wiring <strong>(Option B)</strong>, silver-wiring</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Not prominent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retinal hemorrhages</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Few flame-shaped at <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Numerous flame-shaped hemorrhages</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exudates</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hard exudates, macular-star <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Focal <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"e02b09c05d1692777195005fabe27f\">periarterial</span> transudates (FIPTs)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>More prominent and widespread</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Choroidal involvement</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absent</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Elschnig’s spots</strong>, <strong>Siegrist’s streaks</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic neuropathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absent/minimal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Papilledema</strong>, <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve ischemia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KRXvZHkNVzws24u8aZt01746088041.mp3", "video": ""}, {"text": "A 55-year-old patient with a history of uncontrolled hypertension presents for a routine eye examination. Fundoscopy reveals arteriolar narrowing and changes in the arteriovenous (A-V) ratio. What is the most likely A-V ratio finding in this patient with hypertensive retinopathy?", "options": [{"label": "A", "text": "2:3", "correct": false}, {"label": "B", "text": "1:2", "correct": false}, {"label": "C", "text": "1:3", "correct": true}, {"label": "D", "text": "3:2", "correct": false}], "correct_answer": "C. 1:3", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/TQqtpPKIeafSQEGbI2bX1746088220.mp3", "video": ""}, {"text": "All of the following are considered risk factors for the development of central retinal vein occlusion (CRVO), except?", "options": [{"label": "A", "text": "Age over 50 years", "correct": false}, {"label": "B", "text": "Open-angle glaucoma", "correct": false}, {"label": "C", "text": "Hyperthyroidism", "correct": true}, {"label": "D", "text": "Hypertension", "correct": false}], "correct_answer": "C. Hyperthyroidism", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Age &gt; 50 years (primary risk factor) <strong>(Option A)</strong>,</li>\n<li>Hypertension <strong>(Option D)</strong>,</li>\n<li>Open-angle <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> <strong>(Option B)</strong>,</li>\n<li>Diabetes</li>\n<li>Hyperlipidemia.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Additional Risk Factors</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Smoking, <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc edema, oral contraceptives, hypercoagulable states (e.g., polycythemia, multiple myeloma, antiphospholipid syndrome, hyperhomocysteinemia, etc.), syphilis, HIV, sickle cell disease.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The exact <span class=\"customMeta\" data-dictid=\"4711a65634169277718737b781005d\">etiology</span> is unknown, but the<strong> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> of the Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> to the <span class=\"customMeta\" data-dictid=\"9864ad42b21692777191febeee1002\">lamina</span> cribrosa of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve typically by thrombosis</strong>, is a key mechanism. This is contributed by <strong>venous <span class=\"customMeta\" data-dictid=\"ea73ce564216927771989ea1aa2c3d\">stasis</span> and hypercoagulability</strong>. <strong>Atherosclerosis in the artery</strong> can lead to <span class=\"customMeta\" data-dictid=\"56af81fad316927771843d2b4b1e4f\">compression</span> of the adjacent vein.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/peHMXgtw43MZAHcKjzYW1746088445.mp3", "video": ""}, {"text": "A 65-year-old male presents with sudden, severe vision loss in his left eye. On examination, a relative afferent pupillary defect (RAPD) is present. Fundus examination reveals the following changes: Based on these findings, what is the most likely diagnosis?", "options": [{"label": "A", "text": "Non-ischemic CRVO", "correct": false}, {"label": "B", "text": "Ischemic CRVO", "correct": true}, {"label": "C", "text": "Branch Retinal Vein Occlusion (BRVO)", "correct": false}, {"label": "D", "text": "Diabetic Retinopathy", "correct": false}], "correct_answer": "B. Ischemic CRVO", "question_images": ["https://image.prepladder.com/notes/1k7s1fHGZtN6GWC48QgD1743693759.png"], "explanation_images": ["https://image.prepladder.com/notes/miVyfUdUnRiYWRVVZDjS1743693811.png", "https://image.prepladder.com/notes/1k7s1fHGZtN6GWC48QgD1743693759.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:642px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-ischemic CRVO (Venous <span class=\"customMeta\" data-dictid=\"ea73ce564216927771989ea1aa2c3d\">Stasis</span> Retinopathy)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ischemic CRVO (Hemorrhagic Retinopathy)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Prevalence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>75% of cases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>25% of cases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vision</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild to moderate blurring</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Severe, sudden vision loss</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>RAPD</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absent or mild</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">Fundus</span> Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> congestion, <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> flame-shaped hemorrhages, mild/no <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Massive <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> engorgement, \"splashed-tomato\" hemorrhages, cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots, <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Late <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">Fundus</span> Findings</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vein sheathing, <span class=\"customMeta\" data-dictid=\"1e99ed05df169277718456b9311c0d\">cilioretinal</span> collaterals, absorbed hemorrhages, chronic <span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\">cystoid</span> edema</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Marked <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> sheathing, collaterals, neovascularization, chronic <span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\">cystoid</span> edema</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>15-30% convert to ischemic CRVO</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Neovascular glaucoma, <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> hemorrhage, proliferative retinopathy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP616\" data-author=\"\" data-hash=\"7241\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/miVyfUdUnRiYWRVVZDjS1743693811.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP615\" data-author=\"\" data-hash=\"7240\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/1k7s1fHGZtN6GWC48QgD1743693759.png\"/></td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uk6e9CxfSdU7HXGJOBmr1746088592.mp3", "video": ""}, {"text": "Which of the following investigations is most useful in distinguishing ischemic CRVO from non-ischemic CRVO?", "options": [{"label": "A", "text": "Fundus Autofluorescence (FAF)", "correct": false}, {"label": "B", "text": "Optical Coherence Tomography (OCT)", "correct": false}, {"label": "C", "text": "Goldmann Perimetry and Electroretinogram (ERG)", "correct": true}, {"label": "D", "text": "Slit-lamp Examination", "correct": false}], "correct_answer": "C. Goldmann Perimetry and Electroretinogram (ERG)", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/NSE4P7K3DADpn4aSR9GJ1743693927.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h3><strong>Investigations </strong></h3>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ocular Examination</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Visual <span class=\"customMeta\" data-dictid=\"80d33aa6081692777180a22947db2c\">acuity</span> monitoring</li>\n<li>IOP measurement</li>\n<li>Slit-lamp examination for <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> of the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> (NVI)</li>\n<li>Gonioscopy to exclude <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> of the angle (NVA)</li>\n<li>Fundus examination (direct and indirect)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ocular Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Goldmann perimetry</strong>: Important for differentiating <span class=\"customMeta\" data-dictid=\"d01e44abab16927772010db8725801\">visual field</span> defects in ischemic from non-ischemic CRVO.</li>\n<li><strong>ERG</strong>: <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">Reduced</span> b-wave <span class=\"customMeta\" data-dictid=\"4c75de951316927771819cdfdbdd6a\">amplitude</span> in ischemic CRVO.</li>\n<li><strong>Fundus <span class=\"customMeta\" data-dictid=\"6eef650ea516927771824e945008e5\">autofluorescence</span> (FAF)</strong>: Demonstrates<strong> fern-like perivenular <span class=\"customMeta\" data-dictid=\"7b396b336f16927771894ed574ed88\">hypo</span> autofluorescence</strong> due to <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> edema.</li>\n<li><strong>FFA</strong>: Assess <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"33dfead74b1692777195931780bd9e\">perfusion</span> (Ischemic CRVO shows &gt;10 disc areas of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> non-perfusion).</li>\n<li><strong>OCT</strong>: To evaluate <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, sub-retinal fluid, and <span class=\"customMeta\" data-dictid=\"6aadb11fcb169277718789588782cc\">epiretinal</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> (ERM) formation.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Systemic Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Check for hypertension, diabetes, dyslipidemia, hypercoagulable states, homocysteinemia.</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medical Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Intravitreal steroids</strong> (triamcinolone, dexamethasone)</li>\n<li><strong>Intravitreal anti-VEGF </strong>(Bevacizumab, Ranibizumab)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Laser Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Panretinal <span class=\"customMeta\" data-dictid=\"10cb4498ea1692777195b60ee356a3\">Photocoagulation</span> (PRP)</strong>: Indicated when <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> occurs (NVI, NVA, NVE, or NVD).</li>\n<li><strong>Grid Laser</strong>: Not recommended for <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> in CRVO.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Surgical Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pars <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> <span class=\"customMeta\" data-dictid=\"e6aa17c07816927772024116d41015\">vitrectomy</span> (PPV)</strong> for complications (vitreous hemorrhage, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, ERM)</p>\n<p>Glaucoma <span class=\"customMeta\" data-dictid=\"dd824a31e71692777186c7f8168998\">drainage</span> devices for <span class=\"customMeta\" data-dictid=\"624c00049d1692777193b1a9d81379\">neovascular</span> glaucoma.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ShCwT2RAEODD4ZzEMj461746088883.mp3", "video": ""}, {"text": "A 72-year-old man with a history of hypertension presents with sudden, painless vision loss in his right eye. Which of the following findings is most consistent with the diagnosis of central retinal artery occlusion?", "options": [{"label": "A", "text": "Retinal hemorrhages and cotton wool spots", "correct": false}, {"label": "B", "text": "Optic disc edema and retinal hemorrhages", "correct": false}, {"label": "C", "text": "Dilated retinal veins with tortuosity", "correct": false}, {"label": "D", "text": "Pale retina with a cherry-red spot at the macula", "correct": true}], "correct_answer": "D. Pale retina with a cherry-red spot at the macula", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/tOC8OeIVYCmS5wAc0AVr1746100174.mp3", "video": ""}, {"text": "A 58-year-old male with Type 2 diabetes undergoes a fundus examination, revealing extensive retinal hemorrhages, cotton wool spots, venous beading, and moderate intraretinal microvascular abnormalities (IRMA) in one quadrant. What is the most appropriate follow-up interval for this patient?", "options": [{"label": "A", "text": "2 months", "correct": false}, {"label": "B", "text": "4 months", "correct": true}, {"label": "C", "text": "6 months", "correct": false}, {"label": "D", "text": "12 months", "correct": false}], "correct_answer": "B. 4 months", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/NaQr9oj4ljf8rlicHs5Z1743687156.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:672px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Category </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Management </strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Non-Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">Retinopathy</span> (NPDR)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>No <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Review in 12 months</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Very Mild NPDR</strong></p>\n<p>Microaneurysms only</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Review most patients in 12 months</p>\n<p><strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mild NPDR </strong></p>\n<p>Any or all of the: microaneurysms, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages, exudates, and <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, up to the level of moderate NPDR. No <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> anomalies (IRMA) or significant beading.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Review range 6-12 months, depending on the severity of signs, stability, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> factors, and patient's circumstances</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Moderate NPDR </strong></p>\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages in 1-3 quadrants or mild IRMA</li>\n<li>Significant <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> can be present in no more than 1 quadrant</li>\n<li>Cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots commonly present</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Review in approximately 6 months</p>\n<p><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Severe NPDR </strong></p>\n<p>The 4-2-1 rule; is one or more of the:</p>\n<ul>\n<li>Severe hemorrhages in all 4 quadrants</li>\n<li>Significant <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> in 2 or more quadrants</li>\n<li>Moderate IRMA in 1 or more quadrants</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Review in 4 months <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Very severe NPDR </strong></p>\n<p>Two or more of the criteria for severe NPDR</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Review in 2-3 months <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">Retinopathy</span> (PDR)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mild-moderate PDR </strong></p>\n<p>New vessels on the disc (NVD) or new vessels elsewhere (NVE), but extent insufficient to meet the high-risk criteria</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment is considered according to the severity of signs, stability, <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> factors, and the patient's circumstances such as reliability of attendance for review. If not treated,<strong> review in up to 2 months</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>High-risk PDR </strong></p>\n<ul>\n<li>NVD greater than ⅓ disc area</li>\n<li>Any NVD with <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> hemorrhage</li>\n<li>NVE greater than ½ disc area with <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> hemorrhage</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treatment should be performed <strong>immediately</strong> when possible and certainly on the same day if <span class=\"customMeta\" data-dictid=\"509310d4411692777199f2ffdb7769\">symptomatic</span> presentation with a good <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> view</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Advanced <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> eye disease</strong></p>\n<p>Is characterized by tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment. Significant persistent <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> and <span class=\"customMeta\" data-dictid=\"624c00049d1692777193b1a9d81379\">neovascular</span> glaucoma.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitreoretinal surgery with photocoagulation</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/oGf3FaMc6jIQcPEkgYHU1746085955.mp3", "video": ""}, {"text": "A cherry-red spot is seen on the retina due to thickening and loss of transparency of the retina at the posterior pole. Which of the following diseases are least associated with this finding on fundoscopy?", "options": [{"label": "A", "text": "Tay-Sachs disease", "correct": false}, {"label": "B", "text": "Farber disease", "correct": false}, {"label": "C", "text": "Central retinal artery occlusion", "correct": false}, {"label": "D", "text": "Central retinal vein occlusion", "correct": true}], "correct_answer": "D. Central retinal vein occlusion", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/bSv17vyBOjj4awx6kNH01743694102.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fVDgVtCOfqKLnsV8sfyN1746100498.mp3", "video": ""}, {"text": "A patient is being examined for loss of vision in the ophthalmology clinic. His peripheral visual field is lost, and only his central vision remains. Which of the following would not present with central (tunnel) vision?", "options": [{"label": "A", "text": "Advanced glaucoma", "correct": false}, {"label": "B", "text": "Retinitis pigmentosa", "correct": false}, {"label": "C", "text": "CRAO with cilioretinal artery", "correct": false}, {"label": "D", "text": "Tobacco amblyopia", "correct": true}], "correct_answer": "D. Tobacco amblyopia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/pBHYLjehHzaPpIF4Y8Ve1746100763.mp3", "video": ""}, {"text": "A premature infant, born at 26 weeks of gestation, is receiving oxygen therapy in the neonatal intensive care unit. Retinal examination at 4 weeks post-birth reveals signs of retinal vascular abnormalities. Which of the following mechanisms is most likely responsible for the pathogenesis of retinopathy of prematurity in this patient?", "options": [{"label": "A", "text": "Increased oxygen supply leading to retinal vasodilation", "correct": false}, {"label": "B", "text": "Disruption of VEGF production", "correct": true}, {"label": "C", "text": "Excessive blood glucose levels", "correct": false}, {"label": "D", "text": "Retinal hypoxia leading to abnormal collagen formation", "correct": false}], "correct_answer": "B. Disruption of VEGF production", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Vv9hczft8ddLR4ni0iJ01746101681.mp3", "video": ""}, {"text": "Which of the following is the most significant risk factor for Retinopathy of Prematurity (ROP)?", "options": [{"label": "A", "text": "High birth weight", "correct": false}, {"label": "B", "text": "Prematurity and low birth weight", "correct": true}, {"label": "C", "text": "Prolonged exposure to blue light", "correct": false}, {"label": "D", "text": "Deficiency of Vitamin A", "correct": false}], "correct_answer": "B. Prematurity and low birth weight", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2g1ZOaG41OUdM0DPvKkr1746101920.mp3", "video": ""}, {"text": "A 32-week premature infant presents with dilated and tortuous retinal vessels in the posterior pole, poor pupil dilation, and vitreous haze, indicating a progression of retinopathy of prematurity (ROP). What is the most likely diagnosis?", "options": [{"label": "A", "text": "Rush disease", "correct": false}, {"label": "B", "text": "Plus disease", "correct": true}, {"label": "C", "text": "Cicatricial ROP", "correct": false}, {"label": "D", "text": "Stage 4 ROP", "correct": false}], "correct_answer": "B. Plus disease", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/nZrWKuPkWP6PWDjHq6js1743694614.png", "https://image.prepladder.com/notes/D1ldtzsCkKuZx3f3K5li1743694648.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<h3><strong>Plus Disease </strong></h3>\n<h3><strong>(Option B)</strong></h3>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Rush Disease/ Aggressive <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">Posterior</span> <span class=\"customMeta\" data-dictid=\"0264bf3f371692777197f91c03c523\">ROP</span> </strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>\n<p>Defined by <span class=\"customMeta\" data-dictid=\"29a08d8f9216927771869ed797367e\">dilatation</span> and tortuosity of <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole vessels in at least two quadrants with any stage of ROP.</p>\n</li>\n<li>\n<p>Associated with <span class=\"customMeta\" data-dictid=\"02316c22e31692777187878aa0e0f7\">engorgement</span> and <span class=\"customMeta\" data-dictid=\"29a08d8f9216927771869ed797367e\">dilatation</span> of the <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> vessel, poor <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> <span class=\"customMeta\" data-dictid=\"d141b433d2169277718681e3ff6bc3\">dilation</span> and <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> haze.</p>\n</li>\n<li>\n<p>Indicates a tendency for disease progression.</p>\n</li>\n</ul>\n<p><img alt=\"OP624\" data-author=\"\" data-hash=\"7249\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/nZrWKuPkWP6PWDjHq6js1743694614.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Located in zone I or <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> zone II with severe plus disease.</li>\n<li>Characterized by flat <span class=\"customMeta\" data-dictid=\"8eedb6cec61692777196a6a3b93d3f\">proliferation</span> with <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> loops, hemorrhages and absence of any stage.</li>\n<li>Requires immediate treatment due to rapid progression.</li>\n<li>Can progress directly to stage 5 <span class=\"customMeta\" data-dictid=\"0264bf3f371692777197f91c03c523\">ROP</span> without passing through earlier stages.</li>\n<li><img alt=\"OP625\" data-author=\"\" data-hash=\"7250\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/D1ldtzsCkKuZx3f3K5li1743694648.png\"/></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/g9eKQ1ZIAbEbU8vFxGjU1746118320.mp3", "video": ""}, {"text": "A 23-year-old male presents with sudden, painless vision loss in his left eye. Fundus examination reveals peripheral retinal vasculitis, vessel sheathing and recurrent vitreous hemorrhages. Fluorescein angiography reveals vessel leakage. What is the most appropriate initial treatment?", "options": [{"label": "A", "text": "Intravitreal anti-VEGF therapy", "correct": false}, {"label": "B", "text": "Systemic corticosteroids", "correct": true}, {"label": "C", "text": "Laser photocoagulation", "correct": false}, {"label": "D", "text": "Vitrectomy", "correct": false}], "correct_answer": "B. Systemic corticosteroids", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/csqqJcku3FEj9H4C0zGA1743694888.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:665px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Population Affected</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Young males</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hypersensitivity reaction (Type IV or III) to tuberculoproteins, causing <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> vasculitis, resulting in <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a249eeb5551692777189661d39c1b2\">hypoxia</span> and vasoproliferation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vasculitis Manifestation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vessel sheathing, extensive leakage on <span class=\"customMeta\" data-dictid=\"468accc4d3169277720252132f5b85\">fluorescein</span> angiography</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retinal Changes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Hemorrhages, soft exudates, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> edema, neovascularization, and <span class=\"customMeta\" data-dictid=\"3c19af349e16927771825f314a4a84\">arteriovenous</span> <span class=\"customMeta\" data-dictid=\"950826ab361692777198366a25dfbf\">shunt</span> vessels</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Recurrent <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> hemorrhage, tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, secondary glaucoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Initial Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Systemic steroids for early vasculitis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Further Management</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Photocoagulation for vessels under traction, <span class=\"customMeta\" data-dictid=\"a976f964891692777202dc04f9cf94\">vitreoretinal</span> surgery for severe cases</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3fEHbCcHBpoEjnPikVwP1746119174.mp3", "video": ""}, {"text": "A 3-year-old child is brought to the clinic with a white reflex (leukocoria) noticed in the right eye. An ocular B-scan ultrasound performed to evaluate the child shows a well-defined, echogenic mass within the globe, with associated calcifications. Which is the most likely diagnosis?", "options": [{"label": "A", "text": "Retinal detachment", "correct": false}, {"label": "B", "text": "Vitreous hemorrhage", "correct": false}, {"label": "C", "text": "Retinoblastoma", "correct": true}, {"label": "D", "text": "Choroidal malignant melanoma", "correct": false}], "correct_answer": "C. Retinoblastoma", "question_images": ["https://image.prepladder.com/notes/tnfflkH8Ry1Ree4gddp51743686761.png"], "explanation_images": ["https://image.prepladder.com/notes/tnfflkH8Ry1Ree4gddp51743686761.png", "https://image.prepladder.com/notes/aFtEk3LcnWGkTozDzUxS1743002866.png", "https://image.prepladder.com/notes/ulBwuukpzhemnPR0sW0n1743003242.png", "https://image.prepladder.com/notes/tNfoyIO4Cog2RZRbY9Em1743002977.png", "https://image.prepladder.com/notes/VDd6MkItFuNGQlzmL3Jp1743003107.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HffuNrho6DZc0gK6jOMj1745217057.mp3", "video": ""}, {"text": "What is the approximate distance of the fovea from the optic disc in a normal eye?", "options": [{"label": "A", "text": "1 disc diameter temporal to the optic disc", "correct": false}, {"label": "B", "text": "2 disc diameters nasal to the optic disc", "correct": false}, {"label": "C", "text": "2 disc diameters temporal to the optic disc", "correct": true}, {"label": "D", "text": "1 disc diameter nasal to the optic disc", "correct": false}], "correct_answer": "C. 2 disc diameters temporal to the optic disc", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/rBWZwOftOJOISWA9gPYP1743684075.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:691px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Structure</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Function</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Macula lutea (clinical <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A 5.5 mm <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> cone-rich region in the retina.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Responsible for <span class=\"customMeta\" data-dictid=\"01f54c5c291692777184570c298c6d\">central vision</span> and color vision.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fovea</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A 1.5 mm <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> area at the center of the macula, 2 disc diameters <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> to the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Provides sharp, detailed vision.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Foveola</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A 0.35 mm <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> central depression within the fovea, often shows a bright foveal reflex.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contains only cones, facilitating the highest visual acuity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Foveal <span class=\"customMeta\" data-dictid=\"a44009963c1692777182feb479b12b\">avascular</span> zone</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A 0.4–0.6 mm <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> zone surrounds the foveola, devoid of <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> blood vessels.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Enhances visual clarity by reducing <span class=\"customMeta\" data-dictid=\"f087a3103216927771903f59008962\">interference</span> from blood vessels.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hpgAO69ZMSDaH3WYLgep1745162708.mp3", "video": ""}, {"text": "In which layer of the retina, as labeled in the histology image, are the cell bodies of bipolar cells located?", "options": [{"label": "A", "text": "A", "correct": false}, {"label": "B", "text": "B", "correct": true}, {"label": "C", "text": "C", "correct": false}, {"label": "D", "text": "D", "correct": false}], "correct_answer": "B. B", "question_images": ["https://image.prepladder.com/notes/DeqrO0PErQvzHqjYJBN91743001189.png"], "explanation_images": ["https://image.prepladder.com/notes/U8G5V9LjDHQZw7R2E9I51743001337.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>1. <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">Pigment</span> Epithelium</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Outermost layer with a single <span class=\"customMeta\" data-dictid=\"85dafbf32f1692777195b9d9f035d8\">pigmented</span> cell layer; adheres to Bruch's membrane; supports <span class=\"customMeta\" data-dictid=\"0d7d7c885216927771935437653141\">neurosensory</span> retina, and reduces reflection.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subretinal Space:</strong> This is the layer between the <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">Pigment</span> <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> and the layer of Photoreceptors.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>2. Rods and Cones Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contains the outer segments of <strong>photoreceptors (rods and cones, which are the first-order neurons)</strong>; rods detect low-light vision, cones manage color and detailed vision.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>3. External Limiting Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <span class=\"customMeta\" data-dictid=\"f2fe04f3c7169277719614074303ec\">porous</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> allows processes from rods and cones to pass through.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>4. Outer Nuclear Layer</strong><br/>\n<strong>(Henle’s layer) </strong><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contains the <span class=\"customMeta\" data-dictid=\"e6b47028191692777193eb698e43b6\">nuclei</span> of the <span class=\"customMeta\" data-dictid=\"61b0f28598169277719523480b9ee4\">photoreceptor</span> cells (rods and cones).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>5. Outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">Plexiform</span> Layer </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Includes connections between rods, cones, <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cell dendrites, and <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> cells.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>6. Inner Nuclear Layer </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Made up of the<strong> </strong><strong>cell bodies of <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cells</strong><strong> (which are the second-order neurons)</strong>, <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> cells, <span class=\"customMeta\" data-dictid=\"91407dbf141692777181d103817280\">amacrine</span> cells, and Müller cells; and also contains <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> capillaries.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>7. Inner <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">Plexiform</span> Layer </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Houses <span class=\"customMeta\" data-dictid=\"5c4592475a1692777199991c761d11\">synaptic</span> connections between <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cell axons, <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">ganglion</span> cell dendrites, and <span class=\"customMeta\" data-dictid=\"91407dbf141692777181d103817280\">amacrine</span> cell processes.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>8. <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">Ganglion</span> Cell Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Contains <strong>ganglion cell bodies, which serve as third-order neurons</strong>; midget cells <span class=\"customMeta\" data-dictid=\"12a0ce16121692777199554dcff349\">synapse</span> with a single <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cell, and <span class=\"customMeta\" data-dictid=\"45adef7aa11692777196441a21222f\">polysynaptic</span> cells <span class=\"customMeta\" data-dictid=\"12a0ce16121692777199554dcff349\">synapse</span> with multiple.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>9. Nerve Fiber Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Composed of <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">ganglion</span> cell axons that <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve after passing through the <span class=\"customMeta\" data-dictid=\"9864ad42b21692777191febeee1002\">lamina</span> cribrosa.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>10. Internal Limiting Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The innermost layer separating the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> from the vitreous; is formed by the <span class=\"customMeta\" data-dictid=\"16b76d1d1c1692777200240efcb0e2\">terminal</span> expansions of Müller cells, serving as a basement membrane.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/V2tbe9308hJBdm6mUYHv1745163027.mp3", "video": ""}, {"text": "A 65-year-old male with a history of hypertension and atherosclerosis presents with sudden, painless loss of vision in his left eye. On fundoscopy, you note a pale retina with a cherry-red spot at the macula. What is the most likely underlying cause of this condition?", "options": [{"label": "A", "text": "Diabetic Retinopathy", "correct": false}, {"label": "B", "text": "Central Retinal Artery Occlusion", "correct": true}, {"label": "C", "text": "Central Retinal Vein Occlusion", "correct": false}, {"label": "D", "text": "Optic Neuritis", "correct": false}], "correct_answer": "B. Central Retinal Artery Occlusion", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5U2LGs9z5ec5Vv6ElDGw1745163637.mp3", "video": ""}, {"text": "Which of the following arteries is primarily responsible for supplying the inner layers of the retina?", "options": [{"label": "A", "text": "Central retinal artery", "correct": true}, {"label": "B", "text": "Short posterior ciliary arteries", "correct": false}, {"label": "C", "text": "Long posterior ciliary arteries", "correct": false}, {"label": "D", "text": "Ophthalmic artery", "correct": false}], "correct_answer": "A. Central retinal artery", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/nnaanjlusx3Ii7kKBm2S1743001673.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Layer/Region</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Blood Supply</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Relevance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Outer four layers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Supplied by the <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> system (short and long <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Avascular layers</strong>; rely on <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> vessels for nutrition</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inner six layers</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Supplied by the central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (branch of <span class=\"customMeta\" data-dictid=\"c09776e61f1692777194db295c590f\">ophthalmic</span> artery).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Occlusion causes <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> ischemia.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Macula (in some individuals)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Supplied by the <span class=\"customMeta\" data-dictid=\"1e99ed05df169277718456b9311c0d\">cilioretinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> (from <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries).</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Preserves <span class=\"customMeta\" data-dictid=\"01f54c5c291692777184570c298c6d\">central vision</span> during CRAO.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/BTtwybFiAJOjJPl9c1Qn1745163957.mp3", "video": ""}, {"text": "A 55-year-old male with a history of poorly controlled diabetes and hypertension presents with blurred vision. Fundus examination shows bright yellow, well-defined deposits arranged in a star-like pattern around the macula and cloud-like white patches near the optic disc. What is the most likely cause of the yellow deposits?", "options": [{"label": "A", "text": "Soft exudates due to axoplasmic flow blockage", "correct": false}, {"label": "B", "text": "Hard exudates due to leakage of lipids and proteins", "correct": true}, {"label": "C", "text": "Retinal hemorrhages from ruptured microaneurysms", "correct": false}, {"label": "D", "text": "Cotton-wool spots from ischemic swelling of nerve fibers", "correct": false}], "correct_answer": "B. Hard exudates due to leakage of lipids and proteins", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/KUvAuNUKw7PkBbaewveg1743685499.png", "https://image.prepladder.com/notes/IVsPnnaWiKKh4jEpX3oZ1743685440.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:668px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Soft Exudates (Cotton-Wool Spots)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Hard Exudates</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Appearance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Cloud-like, small, ill-defined, whitish patches</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bright yellow, well-defined <span class=\"customMeta\" data-dictid=\"a99114a6c216927771916f45ffc66c\">lipid</span> deposits</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Formation Mechanism</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Caused by <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">ischemia</span> and axonal swelling; <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">blockage</span> of axoplasmic flow <strong>(Option A and D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Formed by leakage of fluid rich in proteins and lipids</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nerve <span class=\"customMeta\" data-dictid=\"3ace01719a1692777202ddafcebbc4\">fibre</span> layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Seen around <strong>leaking microaneurysms (Option C)</strong>, especially in the macula</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Shape</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Indistinct and variable; may change shape quickly</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Radial, star-shaped figure in the <span class=\"customMeta\" data-dictid=\"948746a830169277719140f9f93879\">macula</span> (macular fan/star)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Main Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Hypertensive retinopathy</li>\n<li>Diabetic retinopathy</li>\n<li>Toxemia of pregnancy</li>\n<li>Anemic retinopathy</li>\n<li>Lupus erythematosus (LE)</li>\n<li>Polyarteritis nodosa (PAN)</li>\n<li>Scleroderma</li>\n<li>Leukemic retinopathy</li>\n<li>Retinopathy associated with AIDS</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diabetic retinopathy</li>\n<li>Hypertensive retinopathy</li>\n<li>Coats' disease</li>\n<li>Circinate retinopathy</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP583\" data-author=\"\" data-hash=\"7117\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/KUvAuNUKw7PkBbaewveg1743685499.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP584\" data-author=\"\" data-hash=\"7116\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/IVsPnnaWiKKh4jEpX3oZ1743685440.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/31ul5EvbTQmvKCtaBN1u1745214588.mp3", "video": ""}, {"text": "The blood-retinal barrier separates the blood from the ocular cavity. Which of the following does not constitute the outer blood-retinal barrier?", "options": [{"label": "A", "text": "Bruch’s membrane", "correct": false}, {"label": "B", "text": "Retinal pigmented epithelium", "correct": false}, {"label": "C", "text": "Zona occludens", "correct": false}, {"label": "D", "text": "Retinal vascular endothelial cells", "correct": true}], "correct_answer": "D. Retinal vascular endothelial cells", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zEyr249oKAzKlvhbFafE1743685796.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Outer blood-retinal barrier</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inner <span class=\"customMeta\" data-dictid=\"979e561c2b169277718340ddc85889\">blood-retinal barrier</span> </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Components </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Formed by the adjacent cells of the <strong>retinal <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> epithelium(RPE) (Option B).</strong></li>\n<li>Maintained by tight junctions named <strong>“zonula occludens”</strong> <strong> (Option C).</strong></li>\n<li>RPE rests on the <strong>Bruch’s <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> (Option A</strong><strong>), </strong>which separates the <span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\">neural</span> <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> from the <span class=\"customMeta\" data-dictid=\"87b317afbd16927771844e0e534940\">choroid</span> capillaries.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Formed by the tight junctions between the <strong>endothelial cells of the <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> blood vessels.</strong></li>\n<li>Depends on <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> integrity.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Function </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It prevents the leakage of <span class=\"customMeta\" data-dictid=\"ba366417791692777187229d34e597\">extracellular</span> fluid and nutrients from the <span class=\"customMeta\" data-dictid=\"87b317afbd16927771844e0e534940\">choroid</span> to the outer retina.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Controls <span class=\"customMeta\" data-dictid=\"1c7103a9b516927771955682b6aaa4\">permeability</span> of the <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> blood vessels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Factors affecting the BRB</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Prostaglandins</li>\n<li>Leukotrienes</li>\n<li>Protein <span class=\"customMeta\" data-dictid=\"9863da498e1692777190e1c6515b48\">kinase</span> C</li>\n<li>Nitric oxide</li>\n<li>VEGF</li>\n<li>Other cytokines</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Associated pathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Outer <span class=\"customMeta\" data-dictid=\"c92bc766dd1692777183f2a707cac7\">BRB</span> <strong>damage </strong>is seen in conditions like:\n\t\t\t\t<ul>\n<li>Age-related <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> degeneration</li>\n<li>Central <span class=\"customMeta\" data-dictid=\"3963a2e0fa169277719874304f5705\">serous</span> chorioretinopathy</li>\n<li>Accelerated hypertension</li>\n<li>Toxemia of pregnancy</li>\n</ul>\n</li>\n<li><strong>Breakdown </strong>of outer <span class=\"customMeta\" data-dictid=\"c92bc766dd1692777183f2a707cac7\">BRB</span> leads to:\n\t\t\t\t<ul>\n<li>Retinal <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> or</li>\n<li>RPE detachment</li>\n</ul>\n</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Retinal macroaneurysms</strong> cause a breakage in the inner <span class=\"customMeta\" data-dictid=\"979e561c2b169277718340ddc85889\">blood-retinal barrier</span> and accumulation of fluid within the outer <span class=\"customMeta\" data-dictid=\"0d7d7c885216927771935437653141\">neurosensory</span> retina.</li>\n<li><strong>Involved in conditions like: </strong>\n<ul>\n<li><strong>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema</strong>.</li>\n<li>Diabetic retinopathy</li>\n<li>Retinal <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> occlusion</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/vHZXL68DSmS1cObtblpG1745214894.mp3", "video": ""}, {"text": "A 60-year-old patient with a history of diabetes comes in for a routine check-up for diabetic retinopathy. The patient also has a cataract, causing a hazy view of the ocular media. Which method of study would be most appropriate for assessing the retina of this patient?", "options": [{"label": "A", "text": "Direct ophthalmoscopy", "correct": false}, {"label": "B", "text": "Indirect ophthalmoscopy", "correct": true}, {"label": "C", "text": "Slit-lamp biomicroscopy", "correct": false}, {"label": "D", "text": "Amsler grid test", "correct": false}], "correct_answer": "B. Indirect ophthalmoscopy", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/fo1cusPEfJfy9zgR2mZj1743682341.png", "https://image.prepladder.com/notes/uYXAkbgdL4tUvlv3boQE1743682294.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direct Ophthalmoscopy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Indirect Ophthalmoscopy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Instrument used</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP009\" data-author=\"\" data-hash=\"7045\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/fo1cusPEfJfy9zgR2mZj1743682341.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP008\" data-author=\"\" data-hash=\"7044\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uYXAkbgdL4tUvlv3boQE1743682294.png\"/></td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Image</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Erect, virtual</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Inverted, real</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Magnification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>High magnification</li>\n<li>(~15x in emmetropes, more in myopes, less in hypermetropes)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Moderate <span class=\"customMeta\" data-dictid=\"279228dffd1692777191c834a27177\">magnification</span> (~2.5x with a +20D lens)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Field of View</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Small (~10° or 1-2 disc diameters)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Large (~35° or 8 disc diameters)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Visualization</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Central <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> only</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Central and <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> (up to the <span class=\"customMeta\" data-dictid=\"4ddf5d11d71692777194fac8ecc625\">ora</span> serrata)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Refractive Media</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Poor <span class=\"customMeta\" data-dictid=\"33ba8d60fb16927772029d1067e602\">visualization</span> in hazy or <span class=\"customMeta\" data-dictid=\"295793c5c1169277718471937601fb\">cloudy</span> media <strong>(Option A)</strong></li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Can <span class=\"customMeta\" data-dictid=\"67407c787d1692777202245c791c31\">visualize</span> through hazy media due to stronger <span class=\"customMeta\" data-dictid=\"50ea3b5c7d169277718976889f5ebc\">illumination</span> <strong>(option B)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examination Distance</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Close to the eye (~15 mm from the cornea)</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Performed at a greater distance (~50 cm or an arm’s length)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Patient Position</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Performed in a seated/standing position in a semi-dark room</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Performed with the patient in a <span class=\"customMeta\" data-dictid=\"b0976ea1fd16927771995d5c700a21\">supine</span> or sitting position</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lens Requirement</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>No external lens is required; correcting lenses for <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors are built into the ophthalmoscope</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Requires a <span class=\"customMeta\" data-dictid=\"00ab88c6091692777185ea2685fa40\">convex</span> lens (commonly +20D) to be placed in front of the patient’s eye</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peripheral <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">Lesion</span> Detection</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Limited ability to detect <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> lesions</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Excellent for detecting <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> lesions such as <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> or tears.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XLOCYDcM5qmHjBOAVNai1746080695.mp3", "video": ""}, {"text": "A 60-year-old patient with age-related macular degeneration (ARMD) undergoes Fundus Fluorescein Angiography (FFA), revealing pooling of dye under the retinal pigment epithelium (RPE) and leakage from newly formed vessels beneath the retina. What abnormality is most likely detected on FFA in this patient?", "options": [{"label": "A", "text": "Hyperfluorescence due to dye pooling under detached RPE and neovascularization", "correct": true}, {"label": "B", "text": "Hypofluorescence due to blockage of background fluorescence by retinal hemorrhage", "correct": false}, {"label": "C", "text": "Hypofluorescence due to occlusion of retinal vasculature", "correct": false}, {"label": "D", "text": "Hyperfluorescence due to staining of the optic disc", "correct": false}], "correct_answer": "A. Hyperfluorescence due to dye pooling under detached RPE and neovascularization", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/aGqJHTgMxJJtJhREevN01743686056.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Fluorescence Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"7\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hyperfluorescence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Window <span class=\"customMeta\" data-dictid=\"359a8718a61692777185568ac80abb\">defect</span> in <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> <span class=\"customMeta\" data-dictid=\"53782f88d31692777187177cb73b24\">epithelium</span> (RPE)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Atrophy showing background <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> fluorescence</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Pooling of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> under detached RPE</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Age-related <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"df4f1758e2169277718697ae66f3dd\">degeneration</span> (ARMD) <strong>(Option A)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Pooling of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> under <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> retina</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Central <span class=\"customMeta\" data-dictid=\"3963a2e0fa169277719874304f5705\">serous</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> (<strong>CSR</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Leakage into the <span class=\"customMeta\" data-dictid=\"0d7d7c885216927771935437653141\">neurosensory</span> <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> due to the <span class=\"customMeta\" data-dictid=\"903370f259169277718385f6060dd7\">breakdown</span> of the inner blood-retinal barrier</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Cystoid <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> (<strong>CME</strong>)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Leakage from <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> or <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> neovascularization</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy, <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> <span class=\"customMeta\" data-dictid=\"624c00049d1692777193b1a9d81379\">neovascular</span> <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> in ARMD</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Staining (long <span class=\"customMeta\" data-dictid=\"b668aed705169277719744b6db8f8e\">retention</span> of <span class=\"customMeta\" data-dictid=\"e8a3764ab516927771863f3212fc41\">dye</span> by tissues)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Drusen, normal <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc <strong>(Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Leakage from <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve head</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Papilloedema</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Hypofluorescence</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Blockage of background fluorescence</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Retinal hemorrhage<strong> (Option B)</strong>, hard exudates, <span class=\"customMeta\" data-dictid=\"85dafbf32f1692777195b9d9f035d8\">pigmented</span> clumps</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Occlusion of retinal/choroidal vasculature</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> <strong>(Option C)</strong>, <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> occlusion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Loss of vasculature</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p>Choroideremia, myopic degeneration</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/h0ilQdclYcZ8kstvqeVM1745215970.mp3", "video": ""}, {"text": "A 35-year-old male presents with difficulty in vision, especially at night, and he reports bumping into objects frequently. Upon examination, he is found to have tunnel vision, and the fundus reveals no abnormalities in the posterior pole. Which region of the retina is most likely responsible for his symptoms?", "options": [{"label": "A", "text": "Macula lutea", "correct": false}, {"label": "B", "text": "Fovea centralis", "correct": false}, {"label": "C", "text": "Optic disc", "correct": false}, {"label": "D", "text": "Peripheral retina", "correct": true}], "correct_answer": "D. Peripheral retina", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/x3cfSVogXd2XOzNT02bK1743749423.png", "https://image.prepladder.com/notes/IaiZF70W25NZ3nnLfvTs1743683905.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Part</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Posterior Pole</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The region behind the <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> equator<strong> includes the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc and <span class=\"customMeta\" data-dictid=\"948746a830169277719140f9f93879\">macula</span> lutea</strong>; best examined using <strong>slit-lamp <span class=\"customMeta\" data-dictid=\"5eeb78465e1692777183b11db65160\">biomicroscopy</span> or by direct ophthalmoscopy.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic Disc </strong><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Known as the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve head, it is a pink, vertically <span class=\"customMeta\" data-dictid=\"74793d564816927771943ae4ba74b3\">oval</span> structure, marking the start of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve.</p>\n<p><strong>The <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> Cup</strong> is a depression in the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc through which the central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> and <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">vein</span> pass; the absence of photoreceptors results in the <span class=\"customMeta\" data-dictid=\"6c2c85ae6b16927771950809419a59\">physiological</span> blind spot.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Macula Lutea </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A dark, <span class=\"customMeta\" data-dictid=\"2b3dfc6c971692777202cea51210cd\">yellow spot</span> at the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole, measuring <strong>5.5 mm</strong> in diameter; is responsible for central, high-acuity vision and color detection.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fovea <span class=\"customMeta\" data-dictid=\"9d06bb6ad916927771841ac5cb7458\">Centralis</span> </strong><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Central area of the <span class=\"customMeta\" data-dictid=\"948746a830169277719140f9f93879\">macula</span> (<strong>1.5 mm</strong> in diameter); contains only cones and is the most sensitive part of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> for visual acuity.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Foveola</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>A <strong>0.35 mm</strong> <span class=\"customMeta\" data-dictid=\"afb15e4a331692777186e495b370a1\">diameter</span> shining pit within the fovea, represents the area of highest visual acuity, with the foveal <span class=\"customMeta\" data-dictid=\"a44009963c1692777182feb479b12b\">avascular</span> zone (FAZ) surrounding it.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Peripheral <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">Retina</span> </strong><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extends from the <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"2056156e8d169277718799b9e86725\">equator</span> to the <span class=\"customMeta\" data-dictid=\"4ddf5d11d71692777194fac8ecc625\">ora</span> serrata, examined via <strong>indirect <span class=\"customMeta\" data-dictid=\"5e1068918f16927771941f59541497\">ophthalmoscopy</span> or Goldmann three-mirror lens</strong>. It contains rods, hence responsible for night vision.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ora Serrata</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>The serrated <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> margin is where the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> ends. Here the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> is firmly attached to both the <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> and choroid. <span class=\"customMeta\" data-dictid=\"4bc4237fe3169277719497604c0f00\">Pars</span> <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> extends anteriorly from <span class=\"customMeta\" data-dictid=\"4ddf5d11d71692777194fac8ecc625\">ora</span> serrata.<img alt=\"OP520\" data-author=\"\" data-hash=\"7069\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/IaiZF70W25NZ3nnLfvTs1743683905.png\"/></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hfnqcGWyPac4DhNoCMLl1746079616.mp3", "video": ""}, {"text": "Which of the following electroretinogram (ERG) findings suggests gross disturbances in retinal circulation?", "options": [{"label": "A", "text": "Extinguished ERG response B) Subnormal ERG with a reduced b-wave C) Negative ERG response D) Normal ERG with a diminished c-wave", "correct": false}, {"label": "B", "text": "Subnormal ERG with a reduced b-wave", "correct": false}, {"label": "C", "text": "Negative ERG response", "correct": true}, {"label": "D", "text": "Normal ERG with a diminished c-wave", "correct": false}], "correct_answer": "C. Negative ERG response", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/fYhpn4yLlQJiQmNunS8N1743014211.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:665px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Definition</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Electroretinography (ERG) records changes in the eye's resting potential. It is <span class=\"customMeta\" data-dictid=\"f3063c1d8b169277719018bf869980\">induced</span> by a flash of light.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Parts of ERG</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>A-wave:</strong> Negative wave, likely from <strong>rods and cones (photoreceptors).</strong></li>\n<li><strong>B-wave:</strong> Large positive wave, generated by Müller cells (inner <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> layers) but <strong>reflects <span class=\"customMeta\" data-dictid=\"df4ae006fe1692777183604169e9b2\">bipolar</span> cell activity</strong>.</li>\n<li><strong>C-wave:</strong> Positive wave, related to the <strong>metabolic activity of the <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> epithelium</strong> (RPE), observed in dark-adapted eyes.</li>\n<li>Foveal <span class=\"customMeta\" data-dictid=\"2a080283331692777187f1a881e3d1\">ERG</span> provides information about the <span class=\"customMeta\" data-dictid=\"948746a830169277719140f9f93879\">macula</span> used in diagnosing cataracts.</li>\n<li><img alt=\"ERG\" data-author=\"\" data-hash=\"2564\" data-license=\"\" data-source=\"\" data-tags=\"March2025\" src=\"https://image.prepladder.com/notes/fYhpn4yLlQJiQmNunS8N1743014211.png\"/></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Interpretation</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Response</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inference</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extinguished</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Complete failure in rod and <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> function (e.g., <span class=\"customMeta\" data-dictid=\"45d1f54a631692777195670b446c7e\">pigmentary</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> dystrophy, complete <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> occlusion, old <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, advanced siderosis).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Subnormal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Large areas of the <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> not <span class=\"customMeta\" data-dictid=\"bf1b7e7049169277720354c306d716\">functioning</span> (e.g., early <span class=\"customMeta\" data-dictid=\"4f1a033cae1692777197a3a6937a0c\">retinitis</span> pigmentosa, before ophthalmoscopic signs).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Negative</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Gross disturbances in the <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> circulation.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Clinical uses</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Used in diagnosis and <span class=\"customMeta\" data-dictid=\"e580b4033e169277719609af594c16\">prognosis</span> for <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> disorders</strong> like <span class=\"customMeta\" data-dictid=\"4f1a033cae1692777197a3a6937a0c\">retinitis</span> pigmentosa, Leber's <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> amaurosis, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> ischemia, and <span class=\"customMeta\" data-dictid=\"3e48c7feaa169277718485430831dd\">chorioretinal</span> degenerations.</li>\n<li><strong>Assessment in Unclear Conditions:</strong> Evaluates <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> when <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">fundus</span> examination is not possible (e.g., dense cataract, corneal opacity).</li>\n<li><strong>Infant Vision Assessment:</strong> Assesses <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"9f0942c0b51692777190ee876713e5\">junction</span> in infants with suspected impaired vision.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:middle\">\n<p><strong>Patterns in ERG</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pattern ERG</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Changes in PERG responses can occur in the early stages of <span class=\"customMeta\" data-dictid=\"61e49875801692777188ad5edea804\">glaucoma</span> by measuring the activity of <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"bbd799518a169277718867e02de42f\">ganglion</span> cells (RGCs), often correlating with elevated <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> pressure (IOP).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Multifocal ERG</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>mfERG aids in diagnosing <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> diseases like Stargardt dystrophy, <span class=\"customMeta\" data-dictid=\"1c42c9fe83169277718486ee5a82e9\">cone</span> dystrophy, and <span class=\"customMeta\" data-dictid=\"c8d9b6cbbb1692777194c4bc31f01f\">occult</span> <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> dystrophy.</li>\n<li>mfERG or similar objective tests can be used to screen <span class=\"customMeta\" data-dictid=\"65d6c8e3de1692777184e31e936d9f\">chloroquine</span> and hydroxychloroquine toxicity.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JTqZ96XDwQbFvRWyLHcw1746081988.mp3", "video": ""}, {"text": "A 14-year-old patient presents with progressive visual impairment. Upon examination, there is evidence of vitelliform lesions in the macula. Electro-oculography (EOG) is performed to assess retinal function. What Arden ratio would be expected in a patient with Best disease on electro-oculography (EOG)?", "options": [{"label": "A", "text": "Greater than 2.0", "correct": false}, {"label": "B", "text": "Less than 1.5", "correct": true}, {"label": "C", "text": "Between 1.5 and 2.0", "correct": false}, {"label": "D", "text": "Exactly 1.85", "correct": false}], "correct_answer": "B. Less than 1.5", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:223px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Arden Ratio</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Interpretation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&gt;1.85</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1.85-1.5</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Borderline</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>&lt;1.5</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abnormal</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dTqoVOnqhFJ4PeSe7yId1745221434.mp3", "video": ""}, {"text": "A patient with chronic diabetes mellitus complains of diminished vision. Her fundoscopy showed clinically significant macular edema. Which of the following would not be seen as a progressive change leading to diabetic retinopathy?", "options": [{"label": "A", "text": "Macular ischemia", "correct": false}, {"label": "B", "text": "Neovascularization", "correct": false}, {"label": "C", "text": "Vitreous hemorrhage", "correct": false}, {"label": "D", "text": "Retinal vasoconstriction", "correct": true}], "correct_answer": "D. Retinal vasoconstriction", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:702px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> \n\t\t\t<p><strong>Retinal <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> disorders</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diabetic retinopathy</li>\n<li>Retinal <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> <span class=\"customMeta\" data-dictid=\"3cd09dcb0e1692777194e41a18d184\">occlusive</span> disease</li>\n<li>Retinopathy of prematurity</li>\n<li>Sickle cell retinopathy</li>\n<li>Retinal <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> <span class=\"customMeta\" data-dictid=\"3cd09dcb0e1692777194e41a18d184\">occlusive</span> disease, etc.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n\t\t\t \n\t\t\t<p><strong>General <span class=\"customMeta\" data-dictid=\"715b4caf0316927771943797627d8d\">pathogenesis</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p> </p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Diabetic <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> (DR):</strong></li>\n<li>Capillary basement <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> thickening, endothelial cell damage, RBCs deformation, and rouleaux formation, increased stickiness of platelets, increased <span class=\"customMeta\" data-dictid=\"a0e40688fa169277719572bdb48c92\">plasma</span> viscosity, loss of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> pericytes → <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> <strong>(cotton <span class=\"customMeta\" data-dictid=\"eaae57387d1692777202060f299953\">wool</span> spots)</strong>, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"0f670d10711692777190af4b12fac9\">ischemia</span> → leads to the clinical appearances of DR.</li>\n<li>Progress of<strong> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> changes </strong>in <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy:\n\t\t\t\t<ul>\n<li>Diabetic <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> → <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> ischemia<strong> </strong><strong>(Option A)</strong> → <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> new vessels <strong>(Option B)</strong> → <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">Vitreous</span> <span class=\"customMeta\" data-dictid=\"4642acfc0c16927771880b34fa5174\">hemorrhage</span> <strong>(Option C)</strong> → Tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment.</li>\n</ul>\n</li>\n</ul>\n<p><strong>Hypertensive retinopathy:</strong></p>\n<ul>\n<li>Systemic <span class=\"customMeta\" data-dictid=\"45372f6c361692777189ff3209e642\">hypertension</span> causes <strong>vasoconstriction of <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> arterioles (Option D)</strong></li>\n<li>Arteriosclerosis, increased <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> permeability, and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages lead to retinopathy.</li>\n</ul>\n<p><strong>Retinopathy of prematurity:</strong></p>\n<ul>\n<li>In <span class=\"customMeta\" data-dictid=\"84f13673191692777196762b18e036\">premature</span> infants</li>\n<li>Linked to high-oxygen exposure</li>\n<li>Leads to <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hypoxia</li>\n</ul>\n<p><strong>Sickle cell retinopathy:</strong></p>\n<ul>\n<li>Due to <span class=\"customMeta\" data-dictid=\"458e050fdc16927771809854c9fd53\">abnormal</span> RBCs</li>\n<li>Vascular <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> damage lead to retinopathy.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Js0GiTQ2pZYCoSbZl67J1745221699.mp3", "video": ""}, {"text": "Which of the following statements is false about laser treatment used for vascular diseases of the retina?", "options": [{"label": "A", "text": "Focal laser therapy for diabetic macular edema targets leaking microaneurysms within 300 µm of the fovea.", "correct": true}, {"label": "B", "text": "Grid laser acts on diffuse retinal thickening, at least 500 µm from the fovea and optic disc.", "correct": false}, {"label": "C", "text": "Subthreshold lasers use very short pulses with longer intervals minimizing collateral damage.", "correct": false}, {"label": "D", "text": "Limitations include central vision risks, visual field defects, and the need for multiple sessions.", "correct": false}], "correct_answer": "A. Focal laser therapy for diabetic macular edema targets leaking microaneurysms within 300 µm of the fovea.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/NaQr9oj4ljf8rlicHs5Z1743687156.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:694px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Condition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Therapy </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details </strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"8\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diabetic <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diabetic <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">Macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">Edema</span> (DMO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Focal laser</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Targets leaking microaneurysms within <strong>500 µm</strong> of the fovea</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Grid laser</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Applied to areas of <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> thickening, at least 500 µm from the <span class=\"customMeta\" data-dictid=\"82c2ec751816927772034d164bf755\">fovea</span> and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Modified <span class=\"customMeta\" data-dictid=\"440df3f37a16927771883b385ce82d\">Grid</span> Laser</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Combines <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">focal</span> treatment with <span class=\"customMeta\" data-dictid=\"440df3f37a16927771883b385ce82d\">grid</span> laser for <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> thickening</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Subthreshold (micropulse) diode laser</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uses very short pulses with longer intervals, minimizing <span class=\"customMeta\" data-dictid=\"4de12d1ef31692777184db1d11c6bd\">collateral</span> damage <strong>(Option C)</strong> while stimulating RPE, and allows subfoveal treatment.</p>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Proliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">Retinopathy</span> (PDR)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Scatter laser treatment - <span class=\"customMeta\" data-dictid=\"af2a61a5f31692777194eb2293afa7\">Panretinal</span> <span class=\"customMeta\" data-dictid=\"10cb4498ea1692777195b60ee356a3\">Photocoagulation</span> (PRP)</p>\n<p><img alt=\"OP601\" data-author=\"\" data-hash=\"7121\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/NaQr9oj4ljf8rlicHs5Z1743687156.png\"/></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mainstay treatment; applies laser burns to <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> to induce <span class=\"customMeta\" data-dictid=\"f30740eaeb16927771978fc4c375eb\">regression</span> of neovascularization.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Targeted <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> Photocoagulation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Utilizes FA to target <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> non-perfusion, aiming for <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> regression.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Branch <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">Vein</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">Occlusion</span> (BRVO)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Sector Photocoagulation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Targets on ischemic areas, often combined with anti-VEGF injections.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Macular Laser</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Considered for persistent <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> with good central perfusion.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Subthreshold Laser</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Alternative for <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> treatment</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> <span class=\"customMeta\" data-dictid=\"75ddd4cc7016927772012e0acd424d\">Vein</span> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">Occlusion</span> (CRVO)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Panretinal <span class=\"customMeta\" data-dictid=\"10cb4498ea1692777195b60ee356a3\">Photocoagulation</span> (PRP)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Crucial for treating neovascularization, often supplemented with anti-VEGF injections.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sickle Cell Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Laser or Cryotherapy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ablates <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> non-perfused <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> to minimize <span class=\"customMeta\" data-dictid=\"176e169d7a169277719341dbc83862\">neovascularization</span> stimulus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Coats Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Laser Ablation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Targets leaking areas, often requiring multiple treatments.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eales Disease</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Scatter <span class=\"customMeta\" data-dictid=\"10cb4498ea1692777195b60ee356a3\">Photocoagulation</span> or Cryotherapy</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Treats non-perfused <span class=\"customMeta\" data-dictid=\"f17d8978bd1692777197621051012f\">retina</span> to reduce neovascularization.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Limitations</strong><strong> and considerations</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Visual field defects</li>\n<li>Central vision risks</li>\n<li>Multiple sessions</li>\n<li>Informed consent</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/DFv82iN5mT57NSZftoHj1746084081.mp3", "video": ""}, {"text": "A 60-year-old diabetic patient presents with worsening vision. Fundoscopy reveals retinal edema, microaneurysms, and hard exudates. Which of the following mechanisms is not responsible for the development of diabetic retinopathy?", "options": [{"label": "A", "text": "Protein kinase C activation", "correct": false}, {"label": "B", "text": "Reduced blood viscosity", "correct": true}, {"label": "C", "text": "Increased proangiogenic factors", "correct": false}, {"label": "D", "text": "Breakdown of the blood-retinal barrier", "correct": false}], "correct_answer": "B. Reduced blood viscosity", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/CImdkMI45eOg7Ex8j0ge1743687500.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/M163UXm7dfRwyHhfFAd01746084754.mp3", "video": ""}, {"text": "A 55-year-old patient with a long history of diabetes mellitus presents for a routine eye examination. The ophthalmologist noted several findings in the retinal examination. Which of the following features is least likely to be observed in early nonproliferative diabetic retinopathy (NPDR)?", "options": [{"label": "A", "text": "Microaneurysm", "correct": false}, {"label": "B", "text": "Dot and blot hemorrhages", "correct": false}, {"label": "C", "text": "Hard exudates", "correct": false}, {"label": "D", "text": "Venous beading", "correct": true}], "correct_answer": "D. Venous beading", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/uyGIUciiaoDsJZck4W5A1743687695.png", "https://image.prepladder.com/notes/GvFCq5GUW4PWFIXOSgIm1743687648.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Severity </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Very mild nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microaneurysms only</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Mild nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microaneurysms plus hard exudates, <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, and/or mild <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Moderate nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Microaneurysms plus mild <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities or moderate <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Severe nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Any one</strong> of the following<strong> (4-2-1 Rule)</strong></p>\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages in four quadrants</li>\n<li>Venous <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> in at least two</li>\n<li>Moderately severe <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities (IRMA) in at least one quadrant</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Very severe nonproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">diabetic</span> <span class=\"customMeta\" data-dictid=\"60029fa8cd169277719733357ef47e\">retinopathy</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Any two</strong> of the following <strong>(4-2-1 Rule)</strong></p>\n<ul>\n<li>Severe <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages in four quadrants</li>\n<li>Venous <span class=\"customMeta\" data-dictid=\"965fde0a5a1692777182ae7e8ede4b\">beading</span> in at least two</li>\n<li>Moderately severe <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities (IRMA) in at least one quadrant</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:675px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Early NPDR or Background <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> Retinopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Severe NPDR or Preproliferative <span class=\"customMeta\" data-dictid=\"a5603ff98316927771865d7ae41f16\">Diabetic</span> Retinopathy</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Affects small <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> vessels.</li>\n<li><strong>Earliest sign:</strong> <span class=\"customMeta\" data-dictid=\"5246921c041692777192f559aac6c8\">Microaneurysm</span> <strong>(Option A) </strong>\n<ul>\n<li><strong>Fluorescein <span class=\"customMeta\" data-dictid=\"c67cc1bcd3169277718150b3c9d6ab\">angiography</span> (FA):</strong> Tiny hyperfluorescent dots.</li>\n</ul>\n</li>\n<li><strong>Retinal hemorrhages: </strong>Both deep, i.e., in the inner nuclear or outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">plexiform</span> layer (dot and <span class=\"customMeta\" data-dictid=\"2bc990c16116927771830255971ff6\">blot</span> hemorrhage) and superficial, i.e., in nerve fiber layer (splinter or flame-shaped) hemorrhages <strong>(Option B)</strong></li>\n<li><strong>Hard exudates</strong><strong>: </strong>\n<ul>\n<li>White or yellow <span class=\"customMeta\" data-dictid=\"b8ccccd9b81692777202ca2fa976d6\">waxy</span> patches with well-defined margins, often at the <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> pole, in the outer <span class=\"customMeta\" data-dictid=\"946db798c6169277719544d7b31041\">plexiform</span> layer. <strong>(Option C)</strong></li>\n<li><strong>FA: </strong>Hypofluorescence with dense exudates.</li>\n</ul>\n</li>\n<li>Edema is not marked.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Increased inner <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hypoxia:</strong> Leads to multiple <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> hemorrhages, <span class=\"customMeta\" data-dictid=\"ef5bc669a416927771854943d1cfa8\">cotton-wool</span> spots, <span class=\"customMeta\" data-dictid=\"96e7e3fecc16927772018cb9f8c8cd\">venous</span> beading, <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> loops, <span class=\"customMeta\" data-dictid=\"871f3dc691169277719044c0f27f98\">intraretinal</span> <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">microvascular</span> abnormalities (IRMAs), and large areas of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion.</li>\n<li><strong>Cotton-Wool Spots: </strong>\n<ul>\n<li>Also called soft exudates or nerve fiber infarcts.</li>\n<li>Result from ischemia, not exudation.</li>\n<li>Caused by <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> of axoplasmic flow, leading to <span class=\"customMeta\" data-dictid=\"e3d212ebd316927771996e0c472d4a\">swelling</span> and a white, fluffy appearance.</li>\n<li><strong>FA:</strong> <span class=\"customMeta\" data-dictid=\"da6db7b0e21692777203c4075458d3\">Focal</span> hypofluorescence due to local ischemia.</li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Venous Beading</strong><strong>: </strong>\n<ul>\n<li>Indicates sluggish <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> circulation.</li>\n<li>Typically adjacent to large areas of <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion. <strong>(Option D)</strong></li>\n</ul>\n</li>\n</ul>\n<ul>\n<li><strong>Intraretinal <span class=\"customMeta\" data-dictid=\"910047ee281692777192ceee540959\">Microvascular</span> Abnormalities (IRMA):</strong>\n<ul>\n<li>Dilated capillaries act as <span class=\"customMeta\" data-dictid=\"4de12d1ef31692777184db1d11c6bd\">collateral</span> channels.</li>\n<li>Bypass <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> bed and is often seen adjacent to <span class=\"customMeta\" data-dictid=\"89e3252d5b16927771833fb9b432ae\">capillary</span> nonperfusion.</li>\n<li><strong>FA: </strong>Focal hypofluorescence</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP600\" data-author=\"\" data-hash=\"7142\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/uyGIUciiaoDsJZck4W5A1743687695.png\"/></td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><img alt=\"OP599\" data-author=\"\" data-hash=\"7141\" data-license=\"\" data-source=\"\" data-tags=\"April2025\" src=\"https://image.prepladder.com/notes/GvFCq5GUW4PWFIXOSgIm1743687648.png\"/></td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/mP0p5VIpP3AqSVuJxwnW1746085134.mp3", "video": ""}, {"text": "A 60-year-old patient with chronic diabetes is diagnosed with diabetic retinopathy. What is the most specific finding for confirming proliferative diabetic retinopathy (PDR) in this patient?", "options": [{"label": "A", "text": "Cotton-wool spots", "correct": false}, {"label": "B", "text": "Retinal hemorrhage", "correct": false}, {"label": "C", "text": "Neovascularization of disc", "correct": true}, {"label": "D", "text": "Intraretinal microvascular abnormalities", "correct": false}], "correct_answer": "C. Neovascularization of disc", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/x3vznB9hTSJT3tycWXtj1746085784.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 45 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient with rheumatoid arthritis who is noncompliant with treatment presents with complaints of superior field loss of vision for the past week. What is the most likely cause of this condition?", "options": [{"label": "A", "text": "Branched retinal artery occlusion B) Central retinal artery occlusion C) Branched retinal vein occlusion D) Central retinal vein occlusion", "correct": false}, {"label": "B", "text": "Central retinal artery occlusion", "correct": false}, {"label": "C", "text": "Branched retinal vein occlusion", "correct": true}, {"label": "D", "text": "Central retinal vein occlusion", "correct": false}], "correct_answer": "C. Branched retinal vein occlusion", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A patient presents with a nodular swelling near the limbus, which blanches after administering phenylephrine and then recurs. What is the most probable diagnosis?", "options": [{"label": "A", "text": "Episcleritis", "correct": true}, {"label": "B", "text": "Scleritis", "correct": false}, {"label": "C", "text": "Bitot spots", "correct": false}, {"label": "D", "text": "Pterygium", "correct": false}], "correct_answer": "A. Episcleritis", "question_images": ["https://image.prepladder.com/content/xySlXVn9LaET9V0cYGLA1724927289.png"], "explanation_images": ["https://image.prepladder.com/content/L86Fk5ZjQhNW1D0BOCu61724927527.png", "https://image.prepladder.com/content/umE9KIPW09Y5tBsDsMLP1724927373.png"], "explanation": "<p>Correct Option A – E\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis based on the observed blanching of vascularity following the administration of 10 % phenylephrine, as depicted in the provided image?", "options": [{"label": "A", "text": "Nodular episcleritis", "correct": true}, {"label": "B", "text": "Nodular scleritis", "correct": false}, {"label": "C", "text": "Nodular phlycten", "correct": false}, {"label": "D", "text": "Scleral ectasia", "correct": false}], "correct_answer": "A. Nodular episcleritis", "question_images": ["https://image.prepladder.com/content/9SOFlbgt8sqU2iSLh3UD1744974792.png", "https://image.prepladder.com/content/LwpDuzTkSdtHghjLW8OH1744974792.png"], "explanation_images": ["https://image.prepladder.com/content/FIFp1EFrW3XsS4KIOpuZ1744974835.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Episcleritis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Episcleritis refers to <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> of the loose <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissue between the <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> and the conjunctiva</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Idiopathic</strong></p>\n<p><strong>Systemic diseases</strong> - gout, rosacea, psoriasis, and <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissue diseases.</p>\n<p><strong>Hypersensitivity reaction</strong> to <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> <span class=\"customMeta\" data-dictid=\"daf5ee63361692777201129f498a4d\">tubercular</span> or streptococcal toxins.</p>\n<p><strong>Infectious <span class=\"customMeta\" data-dictid=\"43018e28341692777187f32f7cf3af\">episcleritis</span> </strong>- <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> <span class=\"customMeta\" data-dictid=\"03350c16f71692777202dbca70976e\">zoster</span> virus, syphilis, Lyme disease, and tuberculosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Common in young females</li>\n<li>Acute onset redness</li>\n<li>Discomfort - gritty/foreign body sensation</li>\n<li><strong>Mild to no pain</strong></li>\n<li>Resolves spontaneously</li>\n<li>Recurrence is common</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ol>\n<li><strong>Simple episcleritis: </strong>Sectorial (occasionally diffuse) <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> of episclera. The <span class=\"customMeta\" data-dictid=\"2b87f64333169277718751772e06ef\">engorged</span> <span class=\"customMeta\" data-dictid=\"d44bcb72461692777187bb7c5a4d1b\">episcleral</span> vessels are large and run in a <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> direction beneath the conjunctiva</li>\n<li><strong>Nodular episcleritis: </strong>Pink or purple flat <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> surrounded by injection, usually situated 2-3 mm away from the limbus. The <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> is firm, tender can be <strong>moved separately</strong> from the <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> and the overlying <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> also moves freely.</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>10% <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">Topical</span> phenylephrine</strong> blanches overlying conjunctival vessels and inflamed <span class=\"customMeta\" data-dictid=\"d44bcb72461692777187bb7c5a4d1b\">episcleral</span> vessels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Differential diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Conjunctivitis</strong>, which is more superficial; blanching occurs with 2.5% phenylephrine</li>\n<li><strong>Phlyctenulosis (Option C ruled out)</strong></li>\n<li>Inflamed <strong>pinguecula</strong></li>\n<li><strong>Scleritis</strong>, which is deeper and more painful; does not blanch with 10% <span class=\"customMeta\" data-dictid=\"1283d2a60c1692777195ed6d63aa4b\">phenylephrine</span> <strong>(Option B ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Topical NSAIDs</li>\n<li>Topical mild <span class=\"customMeta\" data-dictid=\"a3e96d80e9169277718551158bbcd4\">corticosteroid</span> eye drops</li>\n<li>Topical artificial tears,</li>\n<li>Cold compresses applied to the closed lids may offer <span class=\"customMeta\" data-dictid=\"509310d4411692777199f2ffdb7769\">symptomatic</span> relief from <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> discomfort.</li>\n<li>Systemic NSAIDs</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Vascular plexuses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Locations of Vessels</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Clinical correlation. </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Conjunctival plexus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Most superficial</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Congested in <strong>conjunctivitis</strong>.</li>\n<li><strong>Blanched</strong> with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> vasoconstrictor</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Superficial <span class=\"customMeta\" data-dictid=\"d44bcb72461692777187bb7c5a4d1b\">episcleral</span> plexus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lies at the level of Tenon's capsule.</p>\n<p>Radial configuration.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Congested in <strong>episcleritis</strong>.</li>\n<li><strong>Blanched</strong> with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> vasoconstrictor.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Deep <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> plexus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lies deep to the Tenon's <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> and over the sclera.</p>\n<p>Criss-cross pattern.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Congested in <strong>scleritis</strong>.</li>\n<li><strong>Does not blanch</strong> with a <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> vasoconstrictor.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 5-year-old boy presents with a small nodule on the sclera as shown in the image below. What is the likely diagnosis?", "options": [{"label": "A", "text": "Pterygium", "correct": false}, {"label": "B", "text": "Pinguecula", "correct": false}, {"label": "C", "text": "Dermolipoma", "correct": false}, {"label": "D", "text": "Dermoid cyst", "correct": true}], "correct_answer": "D. Dermoid cyst", "question_images": ["https://image.prepladder.com/content/zP02tClRYyxvoBukBui71745317566.png"], "explanation_images": ["https://image.prepladder.com/content/536KHwWNCaaKHRNGAJVn1745317662.png", "https://image.prepladder.com/content/PEMXYr1hKIXpQ0G28NfY1745317671.png", "https://image.prepladder.com/content/DVU6cGAKTPPEjRLG5D0z1745317679.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable diagnosis of a 35-year-old male with a history of prolonged corneal ulcer who now presents with a deformed eye as shown in the image?", "options": [{"label": "A", "text": "Megalocornea", "correct": false}, {"label": "B", "text": "Conjunctivitis", "correct": false}, {"label": "C", "text": "Buphthalmos", "correct": false}, {"label": "D", "text": "Anterior staphyloma", "correct": true}], "correct_answer": "D. Anterior staphyloma", "question_images": ["https://image.prepladder.com/content/vBR98Ddin8cSbGdBmyyW1747905790.png"], "explanation_images": ["https://image.prepladder.com/content/0efx0kNGYBHTJO9IR8Vp1746101660.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Types of staphyloma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Causes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anterior </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pseudocornea (following corneal ulcer) (Option D)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Intercalary </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Perforating injuries of the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> cornea, marginal corneal ulcer, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> scleritis, and <span class=\"customMeta\" data-dictid=\"516238f054169277719881ad620559\">scleromalacia</span> perforans</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ciliary </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Glaucoma, scleritis, and trauma to the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> region</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Equatorial (approx 14 mm behind the limbus) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Scleritis, degenerative myopia, and chronic uncontrolled glaucoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Posterior</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Degenerative <strong>high <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> myopia</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 15 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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Episclera &gt; Sclera proper &gt; Lamina fusca", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/lCtwkFSMk9Hl7Irf96gD1742997227.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:687px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Layer</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Composition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Remarks</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Episclera</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Thin vascularized. <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissue.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Collagen fibers</li>\n<li>Fibroblasts</li>\n<li>Blood vessels</li>\n<li>Nerves</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Located just outside the <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> proper</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sclera proper</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Relatively <strong>avascular.</strong></li>\n<li>Dense tissue.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Dense <span class=\"customMeta\" data-dictid=\"863f5457381692777190f05632a8b2\">irregular</span> bundles of <span class=\"customMeta\" data-dictid=\"d215f4a56c16927771842f34a24156\">collagen</span> </strong>(compared to the <span class=\"customMeta\" data-dictid=\"38164c48ae169277719493b7318bf5\">orderly</span> arrangement in <strong>the </strong>cornea)</li>\n<li>Elastic fibers Fibroblasts, Proteoglycans</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The thickest layer of the sclera</li>\n<li>Provides <strong>structural support and integrity</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lamina fusca</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Innermost layer.</li>\n<li>Loose connective</li>\n<li>tissue layer.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Melanocytes</strong> (migrated from choroid)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>It contains <span class=\"customMeta\" data-dictid=\"85dafbf32f1692777195b9d9f035d8\">pigmented</span> cells derived from the choroid</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/QhVrRGSgUcpTA8Nkp1ZM1746438605.mp3", "video": ""}, {"text": "Match the scleral apertures with the structures they transmit Scleral Apertures Structures Transmitted A. Anterior scleral apertures 1. Short and long ciliary arteries B. Middle scleral apertures 2. Central retinal artery and vein C. Posterior scleral apertures 3. Anterior ciliary arteries and veins D. Lamina cribrosa 4. Vortex veins", "options": [{"label": "A", "text": "A-3, B-4, C-1, D-2", "correct": true}, {"label": "B", "text": "A-2, B-1, C-4, D-3", "correct": false}, {"label": "C", "text": "A-3, B-2, C-1, D-4", "correct": false}, {"label": "D", "text": "A-3, B-1, C-4, D-2", "correct": false}], "correct_answer": "A. A-3, B-4, C-1, D-2", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/gsuorVO4ckRcLZOm5gUB1742997365.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Apertures</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Location</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Structures transmitted</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Anterior</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3-4 mm <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> to the limbus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> vessels, nerves, and lymphatics</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Middle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4 to 7 mm behind the equator</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4 <span class=\"customMeta\" data-dictid=\"301da8b9181692777202486306bbd2\">vortex</span> veins (Vena verticose)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Posterior </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Around the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> nerve</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>8 to 20 short <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> vessels (circle of Zinn) and nerves</li>\n<li>2 long <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> arteries <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> to short ciliary</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Lamina cribrosa</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Posterior most</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Optic nerve fibers</li>\n<li>Central <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"a66cd3adaa1692777182e77cb23021\">artery</span> and veins.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1TxjqhcinMv2MPF0JIqy1746438788.mp3", "video": ""}, {"text": "A 28-year-old patient presents with painless redness of the eye. The ophthalmologist performed a diagnostic test using 2.5% phenylephrine, and no change was noticed. When 10% phenylephrine is used, the following change occurs. What is the most likely diagnosis? Before application of 10% phenylephrine: After application of 10% phenylephrine:", "options": [{"label": "A", "text": "Conjunctivitis", "correct": false}, {"label": "B", "text": "Scleritis", "correct": false}, {"label": "C", "text": "Episcleritis", "correct": true}, {"label": "D", "text": "Uveitis", "correct": false}], "correct_answer": "C. Episcleritis", "question_images": ["https://image.prepladder.com/notes/xYMdtxTtzogVaCyJzFdY1742997813.png", "https://image.prepladder.com/notes/i5dL0MEt00DPKrIhnVMr1742997841.png"], "explanation_images": ["https://image.prepladder.com/notes/5BUiF1MOSOkDwNrJT8rY1742998081.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Episcleritis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Episcleritis refers to <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> of the loose <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissue between the <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> and the conjunctiva</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Idiopathic</strong></li>\n<li><strong>Systemic diseases</strong> - gout, rosacea, psoriasis, and <span class=\"customMeta\" data-dictid=\"67e237a57c16927771859803f93ab3\">connective</span> tissue diseases.</li>\n<li><strong>Hypersensitivity reaction</strong> to <span class=\"customMeta\" data-dictid=\"2a7f0b780c1692777187fe83ec76b1\">endogenous</span> <span class=\"customMeta\" data-dictid=\"daf5ee63361692777201129f498a4d\">tubercular</span> or streptococcal toxins.</li>\n<li><strong>Infectious <span class=\"customMeta\" data-dictid=\"43018e28341692777187f32f7cf3af\">episcleritis</span> </strong>- <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> <span class=\"customMeta\" data-dictid=\"03350c16f71692777202dbca70976e\">zoster</span> virus, syphilis, Lyme disease, and tuberculosis.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Common in young females</li>\n<li>Acute onset redness</li>\n<li>Discomfort - gritty/foreign body sensation</li>\n<li><strong>Mild to no pain</strong></li>\n<li>Resolves spontaneously</li>\n<li>Recurrence is common</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical types</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Simple episcleritis: </strong></p>\n<ul>\n<li>Sectorial (occasionally diffuse) <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> of episclera.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"2b87f64333169277718751772e06ef\">engorged</span> <span class=\"customMeta\" data-dictid=\"d44bcb72461692777187bb7c5a4d1b\">episcleral</span> vessels are large and run in a <span class=\"customMeta\" data-dictid=\"4fff084ff9169277719765c9d85a8e\">radial</span> direction beneath the conjunctiva</li>\n</ul>\n<p><strong>Nodular episcleritis: </strong></p>\n<ul>\n<li>Pink or purple flat <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> surrounded by injection, usually situated 2-3 mm away from the limbus.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"6e6233ba551692777193c62c40bd5f\">nodule</span> is firm, tender can be <strong>moved separately</strong> from the <span class=\"customMeta\" data-dictid=\"3e4400809d16927771983252fc08b1\">sclera</span> and the overlying <span class=\"customMeta\" data-dictid=\"d168af6e7f1692777185683fea5e7f\">conjunctiva</span> also moves freely.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>10% <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">Topical</span> phenylephrine</strong> blanches overlying conjunctival vessels and inflamed <span class=\"customMeta\" data-dictid=\"d44bcb72461692777187bb7c5a4d1b\">episcleral</span> vessels.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Differential diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Conjunctivitis</strong>, which is more superficial; blanching occurs with 2.5% <span class=\"customMeta\" data-dictid=\"1283d2a60c1692777195ed6d63aa4b\">phenylephrine</span> <strong>(Option A ruled out)</strong></li>\n<li><strong>Phlyctenulosis</strong></li>\n<li>Inflamed <strong>pinguecula</strong></li>\n<li><strong>Scleritis</strong>, which is deeper and more painful; does not blanch with 10% <span class=\"customMeta\" data-dictid=\"1283d2a60c1692777195ed6d63aa4b\">phenylephrine</span> <strong>(Option B ruled out)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Topical NSAIDs</li>\n<li>Topical mild <span class=\"customMeta\" data-dictid=\"a3e96d80e9169277718551158bbcd4\">corticosteroid</span> eye drops</li>\n<li>Topical artificial tears,</li>\n<li>Cold compresses applied to the closed lids may offer <span class=\"customMeta\" data-dictid=\"509310d4411692777199f2ffdb7769\">symptomatic</span> relief from <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> discomfort.</li>\n<li>Systemic NSAIDs</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Vascular plexuses</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Locations of Vessels</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical correlation. </strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjunctival plexus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Most superficial</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Congested in <strong>conjunctivitis</strong>.</li>\n<li><strong>Blanched</strong> with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> vasoconstrictor</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superficial <span class=\"customMeta\" data-dictid=\"d44bcb72461692777187bb7c5a4d1b\">episcleral</span> plexus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lies at the level of Tenon's capsule.</li>\n<li>Radial configuration.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Congested in <strong>episcleritis</strong>.</li>\n<li><strong>Blanched</strong> with <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> vasoconstrictor.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Deep <span class=\"customMeta\" data-dictid=\"526ede3fee169277720184378acc5e\">vascular</span> plexus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Lies deep to the Tenon's <span class=\"customMeta\" data-dictid=\"54635b1bf01692777183247ecff5e0\">capsule</span> and over the sclera.</li>\n<li>Criss-cross pattern.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Congested in <strong>scleritis</strong>.</li>\n<li><strong>Does not blanch</strong> with a <span class=\"customMeta\" data-dictid=\"9c5b45e3b916927772000167f2669a\">topical</span> vasoconstrictor.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/R7KCY3w2RJvkHY7QnSa91746439157.mp3", "video": ""}, {"text": "A 40-year-old patient presents with recurrent episodes of episcleritis. After taking a detailed history and performing a thorough systemic examination, which of the following investigations would you consider ordering?", "options": [{"label": "A", "text": "Full blood count and rheumatoid factor (RF)", "correct": false}, {"label": "B", "text": "Mantoux test and antinuclear antibody (ANA)", "correct": false}, {"label": "C", "text": "VDRL and X-rays of the chest and sacroiliac joints", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/eWnOORZEeF8GkgJGWcZe1746439530.mp3", "video": ""}, {"text": "A 45-year-old woman with a 15-year history of rheumatoid arthritis (RA) presents with severe ocular pain, redness, and progressively worsening vision in her left eye for the past 2 weeks. Examination reveals a localized area of scleral thinning with adjacent congestion. There is no posterior involvement on B-scan ultrasound. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Anterior staphyloma", "correct": false}, {"label": "B", "text": "Necrotizing scleritis with inflammation", "correct": true}, {"label": "C", "text": "Nodular scleritis", "correct": false}, {"label": "D", "text": "Scleromalacia perforans", "correct": false}], "correct_answer": "B. Necrotizing scleritis with inflammation", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/rl2ySJ7GaJ8pD11w15A51742998559.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5s5ZgSubKyV2bxCQW0Qo1746440527.mp3", "video": ""}, {"text": "A 38-year-old male presents with persistent eye discomfort, redness, and watering. On examination, the left eye is diffusely tender, sclera appears uniformly reddened and swollen without localized thinning areas. There are no systemic signs of vasculitis or autoimmune disease on further investigation. Which type of anterior scleritis is most consistent with this presentation?", "options": [{"label": "A", "text": "Necrotizing anterior scleritis with inflammation", "correct": false}, {"label": "B", "text": "Non-necrotizing anterior diffuse scleritis", "correct": true}, {"label": "C", "text": "Non-necrotizing anterior nodular scleritis", "correct": false}, {"label": "D", "text": "Scleromalacia perforans", "correct": false}], "correct_answer": "B. Non-necrotizing anterior diffuse scleritis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/NU0aveQXN8RvysRwCic01742998845.png", "https://image.prepladder.com/notes/NvlzlwjVhouRD835jdxT1742998871.png", "https://image.prepladder.com/notes/d5unWffazSoqL4HFbvOR1742999004.png", "https://image.prepladder.com/notes/TwDmjtQmblPH3lM5QM071742999034.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3E3Plas5Nt1bjEKtdi9u1746440855.mp3", "video": ""}, {"text": "A 45-year-old woman presents with severe pain in her right eye, worsened by eye movements, and reduced vision. On examination, proptosis and restricted ocular movements were observed. Ophthalmoscopy shows disc, macular edema, and choroidal folds. Which of the following B-scan ultrasonography findings is most indicative of this disease?", "options": [{"label": "A", "text": "T sign", "correct": true}, {"label": "B", "text": "Moth-Eaten Appearance", "correct": false}, {"label": "C", "text": "Sunray Sign", "correct": false}, {"label": "D", "text": "Kiss Sign", "correct": false}], "correct_answer": "A. T sign", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/nslfAaIHCsIVMcUgqwlZ1742999297.png", "https://image.prepladder.com/notes/gaJo5Uf7QAXXDx4fReoJ1743000306.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qj2MIBdBH29smOTxTGjw1746441494.mp3", "video": ""}, {"text": "A 60-year-old woman with a 20-year history of rheumatoid arthritis has a painless, progressively thinning area in the sclera of her left eye. The area appears as shown in the image below. Which of the following best describes the pathophysiological mechanism responsible for this condition?", "options": [{"label": "A", "text": "Type III hypersensitivity", "correct": true}, {"label": "B", "text": "Type II hypersensitivity", "correct": false}, {"label": "C", "text": "Type IV hypersensitivity", "correct": false}, {"label": "D", "text": "Infective etiology", "correct": false}], "correct_answer": "A. Type III hypersensitivity", "question_images": ["https://image.prepladder.com/notes/TwDmjtQmblPH3lM5QM071742999034.png"], "explanation_images": ["https://image.prepladder.com/notes/TwDmjtQmblPH3lM5QM071742999034.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/i3LGz9DVqZdO0DFI3vt71746442445.mp3", "video": ""}, {"text": "Depending on the location of the staphyloma in the eye which among the following options is matched correctly with its cause?", "options": [{"label": "A", "text": "Anterior staphyloma - Peripheral corneal ulcer", "correct": false}, {"label": "B", "text": "Intercalary staphyloma - Degenerative myopia", "correct": false}, {"label": "C", "text": "Equatorial staphyloma - Scleritis", "correct": true}, {"label": "D", "text": "Ciliary staphyloma - Pseudocornea", "correct": false}], "correct_answer": "C. Equatorial staphyloma - Scleritis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/HouOef7UaPLfz4p955Jh1742999943.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Types of staphyloma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Causes</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Anterior (Option A ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pseudocornea</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Intercalary (Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Perforating injuries of the <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> cornea, marginal corneal ulcer, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> scleritis, and <span class=\"customMeta\" data-dictid=\"516238f054169277719881ad620559\">scleromalacia</span> perforans</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Ciliary (Option D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Glaucoma, scleritis, and trauma to the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> region</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Equatorial </strong>(approx 14 mm behind the limbus)<strong> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Scleritis, degenerative myopia, and chronic uncontrolled glaucoma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Posterior</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Degenerative high <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> myopia</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YY7cTzUwSslQUAaltEM51746442918.mp3", "video": ""}, {"text": "Blue sclera is commonly associated with all of the following conditions except:", "options": [{"label": "A", "text": "Osteogenesis Imperfecta", "correct": false}, {"label": "B", "text": "Ehlers-Danlos Syndrome", "correct": false}, {"label": "C", "text": "Alkaptonuria", "correct": true}, {"label": "D", "text": "Marfan Syndrome", "correct": false}], "correct_answer": "C. Alkaptonuria", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/33nhr7iAWLwoSNKBilU31743000082.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/hyESRV3E7TIpwUPqL2d21746443303.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 20 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "The patient has an infection of the cavernous sinus, involving the nerve located on its medial side. To confirm the involvement of the abducens nerve, you will ask the patient to look in which direction?", "options": [{"label": "A", "text": "Superior", "correct": false}, {"label": "B", "text": "Inferior", "correct": false}, {"label": "C", "text": "Medial", "correct": false}, {"label": "D", "text": "Lateral", "correct": true}], "correct_answer": "D. Lateral", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/YgMbkFYqh6fOVstj6Vlz1747305132.png", "https://image.prepladder.com/notes/zXOxF2Ih2xyxw2hK83As1747655499.png"], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:900px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Abducens Nerve (cranial nerve VI)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Type </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Motor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Origin </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Pons (lower border, opposite the <span class=\"customMeta\" data-dictid=\"70469583201692777196a8f1c66bfc\">pyramid</span> of the medulla).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Course </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p style=\"text-align:center\"><img alt=\"\" data-author=\"\" data-hash=\"\" data-license=\"\" data-source=\"\" data-tags=\"\" height=\"954\" src=\"https://image.prepladder.com/content/YgMbkFYqh6fOVstj6Vlz1747305132.png\" width=\"600\"/></p>\n<p style=\"text-align:center\"><img alt=\"Abducens nerve\" data-author=\"\" data-hash=\"12982\" data-license=\"\" data-source=\"\" data-tags=\"May2025\" height=\"400\" src=\"https://image.prepladder.com/notes/zXOxF2Ih2xyxw2hK83As1747655499.png\" width=\"400\"/></p>\n<p> </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Functional component</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>General <span class=\"customMeta\" data-dictid=\"3db910d8571692777198303e3bcb27\">somatic</span> <span class=\"customMeta\" data-dictid=\"8833ce72c71692777187014d5585e7\">efferent</span> fibres</strong>: Arise from the <strong>abducent nucleu</strong>s in the <span class=\"customMeta\" data-dictid=\"5e4684038e16927771967a14f73f37\">pons</span> and supply the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle of the eyeball.</li>\n<li><strong>General <span class=\"customMeta\" data-dictid=\"3db910d8571692777198303e3bcb27\">somatic</span> <span class=\"customMeta\" data-dictid=\"4dd3bdfe1d1692777180deb3103555\">afferent</span> </strong>fibres carry <span class=\"customMeta\" data-dictid=\"cd38f5515716927771969b9fb17e95\">proprioceptive</span> sensations from the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> and terminate in the <span class=\"customMeta\" data-dictid=\"722dfab4551692777192ec9f24aedf\">mesencephalic</span> <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> of the <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Supply </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Lateral <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle of the eyeball</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical aspect </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lesion or injury (elevated <span class=\"customMeta\" data-dictid=\"cd42e0ddad1692777190d18c595ec5\">intracranial</span> pressure) of the <span class=\"customMeta\" data-dictid=\"493415137f1692777180adce8b5447\">abducens</span> nerve results in <span class=\"customMeta\" data-dictid=\"72fa9105b916927771945aef35e8ed\">paralysis</span> of the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, leading to:</p>\n<ul>\n<li>Inability to <span class=\"customMeta\" data-dictid=\"cc4da2fb151692777180dc699ae203\">abduct</span> the eye <strong>(Option B)</strong></li>\n<li>Diplopia (double vision)</li>\n<li>Convergent <span class=\"customMeta\" data-dictid=\"4d366430b5169277719914874d78a5\">squint</span> (due to the unopposed action of <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> rectus)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the test being shown below.", "options": [{"label": "A", "text": "Obscure test", "correct": false}, {"label": "B", "text": "Prism test", "correct": false}, {"label": "C", "text": "Cover uncover test", "correct": true}, {"label": "D", "text": "Maddox rod test", "correct": false}], "correct_answer": "C. Cover uncover test", "question_images": ["https://image.prepladder.com/content/KDE9hYDj7cJrUDfGlyoV1695190732.png", "https://image.prepladder.com/content/T9gAaYKi02JoUN0S1ktA1695190739.png"], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What should be the subsequent course of action for a patient presenting with one eye displaying convergent squint and visual acuity of 6/60, while the other eye has no squint but also displays visual acuity of 6/60?", "options": [{"label": "A", "text": "MRI", "correct": false}, {"label": "B", "text": "Squint surgery", "correct": false}, {"label": "C", "text": "Botulinum toxin", "correct": false}, {"label": "D", "text": "Refraction", "correct": true}], "correct_answer": "D. Refraction", "question_images": [], "explanation_images": [], "explanation": "\n<table>\n<tbody>\n<tr>\n<td>\n<p><strong>Type of Squint</strong></p>\n</td>\n<td>\n<p><strong>Description</strong></p>\n</td>\n<td>\n<p><strong>Management</strong></p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Esotropia</p>\n</td>\n<td>\n<p>Inward <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> of one or both eyes</p>\n</td>\n<td>\n<p>Observation, glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Exotropia</p>\n</td>\n<td>\n<p>Outward <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> of one or both eyes</p>\n</td>\n<td>\n<p>Observation, glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hypertropia</p>\n</td>\n<td>\n<p>Upward <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> of one or both eyes</p>\n</td>\n<td>\n<p>Observation, glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Hypotropia</p>\n</td>\n<td>\n<p>Downward <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> of one or both eyes</p>\n</td>\n<td>\n<p>Observation, glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Alternating</p>\n</td>\n<td>\n<p>Switching eye <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> between the two eyes</p>\n</td>\n<td>\n<p>Observation, glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Accommodative</p>\n</td>\n<td>\n<p>Eye misalignment due to <span class=\"customMeta\" data-dictid=\"fefa53d9f216927772037e31a651d7\">focusing</span> effort (refractive error)</p>\n</td>\n<td>\n<p>Glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery (rare cases)</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Non-accommodative</p>\n</td>\n<td>\n<p>Eye misalignment not due to <span class=\"customMeta\" data-dictid=\"fefa53d9f216927772037e31a651d7\">focusing</span> effort (neurological)</p>\n</td>\n<td>\n<p>Observation, glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Congenital</p>\n</td>\n<td>\n<p>Present at birth</p>\n</td>\n<td>\n<p>Observation, glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery</p>\n</td>\n</tr>\n<tr>\n<td>\n<p>Acquired</p>\n</td>\n<td>\n<p>Develops later in life due to various causes</p>\n</td>\n<td>\n<p>Treat underlying cause (glasses, patching, <span class=\"customMeta\" data-dictid=\"116a50b7321692777194e1aab5b767\">orthoptic</span> exercises, surgery)</p>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "In a 40-year-old patient with diabetes, a squint was observed. The secondary deviation was higher than the primary deviation during examination. The forced duction test yielded negative results. Which type of squint is expected to be predominant in this individual?", "options": [{"label": "A", "text": "Comitant squint", "correct": false}, {"label": "B", "text": "Restrictive squint", "correct": false}, {"label": "C", "text": "Paralytic squint", "correct": true}, {"label": "D", "text": "Pseudosquint", "correct": false}], "correct_answer": "C. Paralytic squint", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The movement lost on left gaze as depicted in the image is seen in?", "options": [{"label": "A", "text": "3rd CN palsy", "correct": true}, {"label": "B", "text": "4th CN palsy", "correct": false}, {"label": "C", "text": "6th CN palsy", "correct": false}, {"label": "D", "text": "7th CN palsy", "correct": false}], "correct_answer": "A. 3rd CN palsy", "question_images": ["https://image.prepladder.com/content/IQKPYFG0mY7PlOXNjfrl1745240417.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic nerve (CN II)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Purely sensory</li>\n<li>Senses the incoming light and image displayed on retina</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (CN III)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Innervates majority of the <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> muscles</li>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle, <span class=\"customMeta\" data-dictid=\"fd8276624e169277719113f7a44b76\">levator</span> <span class=\"customMeta\" data-dictid=\"4f6407581c1692777194e86eb9904c\">palpebrae</span> superioris muscle, <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle, and the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> muscle.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trochlear nerve (CN IV)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trigeminal Nerve (CN V) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ophthalmic branch of the <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve provides <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the eye</li>\n<li>Afferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Abducens Nerve (CN VI)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Facial Nerve (CN VII)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> of the orbicularis <span class=\"customMeta\" data-dictid=\"7860833ed41692777194b7b9b531f7\">oculi</span> muscle</li>\n<li>Efferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sympathetic Nervous System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves: Innervates the pupillary <span class=\"customMeta\" data-dictid=\"34cb72fd361692777186bfa0354926\">dilator</span> muscles causing mydriasis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parasympathetic nervous system</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Short <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves:<strong> </strong>Innervates the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> pupillae muscles causing miosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following conditions is associated with the finding observed by a physician during an eye examination of a small child?", "options": [{"label": "A", "text": "Myopia", "correct": false}, {"label": "B", "text": "Astigmatism", "correct": false}, {"label": "C", "text": "Hyperopia", "correct": true}, {"label": "D", "text": "Emmetropia", "correct": false}], "correct_answer": "C. Hyperopia", "question_images": ["https://image.prepladder.com/content/rCXHV4G7zgVtfArKrpjR1745239977.png"], "explanation_images": ["https://image.prepladder.com/content/Rs6NL4ZWCdCSMtvZ10Kd1745240051.png", "https://image.prepladder.com/content/iEUrx5aCHZGcobNqL9yP1745240059.png", "https://image.prepladder.com/content/IQ7Jrwl3jARH8IB11FYc1745240069.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The chart depicted in the image is ______?", "options": [{"label": "A", "text": "Hess chart", "correct": true}, {"label": "B", "text": "Snellen chart", "correct": false}, {"label": "C", "text": "Pelli-Robson chart", "correct": false}, {"label": "D", "text": "ETDRS chart", "correct": false}], "correct_answer": "A. Hess chart", "question_images": ["https://image.prepladder.com/notes/Pv0MjXUKgeOHHXtxEFAv1747048140.png"], "explanation_images": ["https://image.prepladder.com/notes/Pv0MjXUKgeOHHXtxEFAv1747048140.png", "https://image.prepladder.com/notes/4HxIu0wpfplMffN1HvOn1745312278.png", "https://image.prepladder.com/notes/eJGU6kR7BCU7doBqcIC51745312331.png", "https://image.prepladder.com/notes/OsJ3hCLcMqYA08atU1MR1745312377.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Identify the condition", "options": [{"label": "A", "text": "Medial rectus palsy", "correct": false}, {"label": "B", "text": "Trochlear nerve palsy", "correct": false}, {"label": "C", "text": "Abducens nerve palsy", "correct": false}, {"label": "D", "text": "Oculomotor nerve palsy", "correct": true}], "correct_answer": "D. Oculomotor nerve palsy", "question_images": ["https://image.prepladder.com/content/yV7cTJ2FvOly7rNayNH51747130644.png"], "explanation_images": ["https://image.prepladder.com/content/kBMUBQKqbhI3TKSHiCMv1747130662.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the likely diagnosis for a 5-year-old girl presenting with decreased best corrected visual acuity in the right eye after a school vision screening revealed diminution of acuity in the right eye without any examination findings of the eye and visual pathway?", "options": [{"label": "A", "text": "Amblyopia", "correct": true}, {"label": "B", "text": "Retinoblastoma", "correct": false}, {"label": "C", "text": "Congenital cataract", "correct": false}, {"label": "D", "text": "Brain lesion", "correct": false}], "correct_answer": "A. Amblyopia", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Key Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Strabismic Amblyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>The brain suppresses input from one eye due to constant <span class=\"customMeta\" data-dictid=\"4d366430b5169277719914874d78a5\">squint</span> (strabismus).</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Common cause; underdevelopment of vision in the deviated eye.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Stimulus <span class=\"customMeta\" data-dictid=\"0a5bb4dd4116927771860470a5e991\">Deprivation</span> <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Hindered vision due to <span class=\"customMeta\" data-dictid=\"39f44b27bf169277719416f29a74ee\">obstruction</span> from early life (e.g., <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> cataracts, ptosis, dense central corneal opacity).</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Lack of visual <span class=\"customMeta\" data-dictid=\"7f3792072b1692777199fd8e2c4f59\">stimulation</span> affects normal development.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Anisometropic <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>A significant difference in <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> error between eyes.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>The brain favours the <span class=\"customMeta\" data-dictid=\"55436411c216927771846e318f45ce\">clearer</span> eye, leading to <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">amblyopia</span> in the other.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Ametropic Amblyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>High uncorrected <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors in both eyes.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral; is less severe compared to other types.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Meridional Amblyopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Uncorrected <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> affecting specific visual meridians.</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Affects one or both eyes depending on the <span class=\"customMeta\" data-dictid=\"e0a7b7e6ec16927771826de64df66b\">astigmatism</span> degree.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the recommended treatment for a 3-year-old child with amblyopia in the right eye?", "options": [{"label": "A", "text": "Observe for 3 months", "correct": false}, {"label": "B", "text": "Occlusion of the right eye", "correct": false}, {"label": "C", "text": "Occlusion of the left eye", "correct": true}, {"label": "D", "text": "Surgical correction", "correct": false}], "correct_answer": "C. Occlusion of the left eye", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Amblyopia treatment should be started as early as possible (younger the child, better the prognosis). <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> therapy works best when initiated in young children under 3 years of age and comprise:</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Occlusion therapy (Option C):</strong> <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">Occlusion</span> of the sound (normal) eye to force use of amblyopic eye is the main stay in the treatment of amblyopia. Following methods are deployed,</p>\n<ul>\n<li><strong>Full-time occlusion: </strong>Up to 2 years, the <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> should be done in 2:1, i.e. 2 days in sound eye and one day in amblyopic eye; at the age of 3 years, 3:1; at the age of 4 years, 4:1; At the age of 5 years, 5:1; and after the age of 6 years 6:1.</li>\n<li><strong>Part-time occlusion:</strong> 4-6 hours/day, as shown by <span class=\"customMeta\" data-dictid=\"48ecf3114716927771818db0abb2a6\">Amblyopia</span> Treatment Study (ATS), and is as effective as full-time occlusion.</li>\n<li><strong>Maintenance occlusion: </strong>After vision equalization, part-time <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> continues until at least 8 years of age.</li>\n<li>Ensure no media <span class=\"customMeta\" data-dictid=\"a8eadab50316927771948be0cc91ca\">opacity</span> or <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">refractive</span> errors before starting <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> therapy.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Other Methods:</strong></p>\n<ul>\n<li><strong>Penalization: </strong>Blurring vision in the sound eye with <span class=\"customMeta\" data-dictid=\"90b10f842b1692777182e4a9268284\">atropine</span> or over-plus lenses.</li>\n<li><strong>Computerized Home Vision Therapy:</strong> Uses specially designed software as an <span class=\"customMeta\" data-dictid=\"e405fcd2f2169277718034536f004a\">adjunct</span> to <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> therapy.</li>\n<li><strong>Pharmacologic Manipulation</strong>\n<ul>\n<li><strong>Levodopa/Carbidopa:</strong> Studied as an <span class=\"customMeta\" data-dictid=\"e405fcd2f2169277718034536f004a\">adjunct</span> to <span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\">occlusion</span> therapy.</li>\n<li>Other agents: Citicoline and <span class=\"customMeta\" data-dictid=\"5e18c6662c16927771946257c6b8d2\">omega</span> <span class=\"customMeta\" data-dictid=\"bc6cd9a9f9169277720261812ea113\">fatty</span> acids</li>\n</ul>\n</li>\n<li><strong>Pleoptics:</strong> Pleoptic exercises are done to improve foveal fixation, though less commonly used now.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 60-year-old male presents with left eyelid drooping and experiencing double vision. Upon examination, it was observed that the pupil in the affected eye was dilated. The following eye movement examination was conducted. Which nerve is most likely injured in this case?", "options": [{"label": "A", "text": "Optic nerve", "correct": false}, {"label": "B", "text": "Oculomotor", "correct": true}, {"label": "C", "text": "Trochlear", "correct": false}, {"label": "D", "text": "Abducens", "correct": false}], "correct_answer": "B. Oculomotor", "question_images": ["https://image.prepladder.com/notes/53XxCGTmZNijao6lRGTq1747910667.png"], "explanation_images": ["https://image.prepladder.com/notes/53XxCGTmZNijao6lRGTq1747910667.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the function of the superior oblique muscle?", "options": [{"label": "A", "text": "Intorsion, abduction, depression", "correct": true}, {"label": "B", "text": "Intorsion, adduction, elevation", "correct": false}, {"label": "C", "text": "Extorsion, abduction, depression", "correct": false}, {"label": "D", "text": "Extorsion, adduction, elevation", "correct": false}], "correct_answer": "A. Intorsion, abduction, depression", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:749px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Extraocular muscles and actions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Muscle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Primary Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Secondary Actions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Innervation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medial Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adduction (moves eye inward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oculomotor nerve (CN III)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abduction (moves eye outward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abducens nerve (CN VI)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elevation (moves eye upward) <strong>(Option B ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intorsion (inward rotation), Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oculomotor nerve (CN III)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Depression (moves eye downward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extorsion (outward rotation), Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oculomotor nerve (CN III)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior Oblique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intorsion (inward rotation)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Depression, Abduction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trochlear nerve (CN IV)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior Oblique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extorsion (outward rotation)</p>\n<p><strong>(Option C &amp; D ruled out)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elevation, Abduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oculomotor nerve (CN III)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the recommended treatment for a 3-year-old child with amblyopia in the right eye?", "options": [{"label": "A", "text": "Observation", "correct": false}, {"label": "B", "text": "Spectacles or refraction with a near addition", "correct": false}, {"label": "C", "text": "Occlusion Therapy", "correct": true}, {"label": "D", "text": "Radial keratotomy", "correct": false}], "correct_answer": "C. Occlusion Therapy", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer C - &lt;span class=\"customMeta\" data-dictid=\"896c5469811692777194e64e7ccef7\"&gt;Occlusion&lt;/span&gt; Th\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is commonly used for refraction in a child with accommodative squint?", "options": [{"label": "A", "text": "1% Atropine", "correct": true}, {"label": "B", "text": "Cyclopentolate", "correct": false}, {"label": "C", "text": "Tropicamide", "correct": false}, {"label": "D", "text": "Homatropine", "correct": false}], "correct_answer": "A. 1% Atropine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Answer A - 1% A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which nerve innervates the lateral rectus muscle?", "options": [{"label": "A", "text": "Sixth nerve", "correct": true}, {"label": "B", "text": "Seventh nerve", "correct": false}, {"label": "C", "text": "Third nerve", "correct": false}, {"label": "D", "text": "Fourth nerve", "correct": false}], "correct_answer": "A. Sixth nerve", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Optic nerve (CN II)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Purely sensory</li>\n<li>Senses the incoming light and image displayed on retina</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (CN III)</strong><strong> (Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Innervates majority of the <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> muscles</li>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">inferior</span> <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle, <span class=\"customMeta\" data-dictid=\"fd8276624e169277719113f7a44b76\">levator</span> <span class=\"customMeta\" data-dictid=\"4f6407581c1692777194e86eb9904c\">palpebrae</span> superioris muscle, <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> muscle, and the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> muscle.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trochlear nerve (CN IV) </strong><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the superior <span class=\"customMeta\" data-dictid=\"dd88c7c9741692777194fe0cc9abaa\">oblique</span> muscle</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trigeminal Nerve (CN V) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Ophthalmic branch of the <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve provides <span class=\"customMeta\" data-dictid=\"408bcde7f01692777198acadb8e1c6\">sensory</span> <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the eye</li>\n<li>Afferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Abducens Nerve (CN VI) </strong><strong>(Option A) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> to the<strong> <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> muscle</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Facial Nerve (CN VII)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Motor <span class=\"customMeta\" data-dictid=\"45b8853be116927771901a9ff3eeb2\">innervation</span> of the orbicularis <span class=\"customMeta\" data-dictid=\"7860833ed41692777194b7b9b531f7\">oculi</span> muscle</li>\n<li>Efferent part of corneal and <span class=\"customMeta\" data-dictid=\"7b8d2e6b3a1692777191cfff333306\">lacrimation</span> reflex</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sympathetic Nervous System</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Long <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves: Innervates the pupillary <span class=\"customMeta\" data-dictid=\"34cb72fd361692777186bfa0354926\">dilator</span> muscles causing mydriasis</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parasympathetic nervous system</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Short <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> nerves:<strong> </strong>Innervates the <span class=\"customMeta\" data-dictid=\"1a73a42f071692777199a59120f494\">sphincter</span> pupillae muscles causing miosis</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The cover-uncover test is performed to diagnose various eye conditions. Which of the following is not detected by this test?", "options": [{"label": "A", "text": "Latent Squint", "correct": false}, {"label": "B", "text": "Manifest Squint", "correct": false}, {"label": "C", "text": "Lateral Nystagmus", "correct": false}, {"label": "D", "text": "Amblyopia", "correct": true}], "correct_answer": "D. Amblyopia", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/xid5Y49PckvPBSIgjrej1741088211.png", "https://image.prepladder.com/content/FNLz61QtW6J0TjCyYz3O1741088228.png"], "explanation": "<p><strong>References:</strong></p>\n<ul><li>↳ Identifies latent deviations or tropias.</li><li>↳ latent deviations or tropias.</li><li>↳ Procedure: Cover one eye and then observe the covered eye when the cover is removed. If the eye reverts to fixation, it indicates a phoria or intermittent tropia . If the eye remains deviated, it suggests a tropia with fixation preference for the fellow eye.</li><li>↳ Procedure:</li><li>↳ Cover one eye and then observe the covered eye when the cover is removed. If the eye reverts to fixation, it indicates a phoria or intermittent tropia . If the eye remains deviated, it suggests a tropia with fixation preference for the fellow eye.</li><li>↳ Cover one eye and then observe the covered eye when the cover is removed.</li><li>↳ If the eye reverts to fixation, it indicates a phoria or intermittent tropia .</li><li>↳ phoria or intermittent tropia</li><li>↳ If the eye remains deviated, it suggests a tropia with fixation preference for the fellow eye.</li><li>↳ tropia with fixation preference for the fellow eye.</li><li>↳ Alternate Cover Test: Detects phorias by dissociating the visual axes.</li><li>↳ Alternate Cover Test:</li><li>↳ Alternate covering each eye to maximize visual axis dissociation. Care must be taken to permit time for each eye to reside behind the cover (the cover must not be “fanned” before the eyes). Use prisms to quantify phorias or tropias. If measurements are unclear, estimate the midpoint between defined movements.</li><li>↳ Alternate covering each eye to maximize visual axis dissociation.</li><li>↳ Care must be taken to permit time for each eye to reside behind the cover (the cover must not be “fanned” before the eyes).</li><li>↳ Use prisms to quantify phorias or tropias. If measurements are unclear, estimate the midpoint between defined movements.</li><li>↳ Lateral Nystagmus (Option C): Nystagmus is involuntary, rhythmic eye movements. The cover-uncover test might exacerbate nystagmus, though it is not the primary test for detecting it.</li><li>↳ Lateral Nystagmus (Option C):</li></u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the probable cause of uniocular diplopia in a young boy who has experienced trauma to his right eye?", "options": [{"label": "A", "text": "Paresis of extraocular muscle", "correct": false}, {"label": "B", "text": "Displacement of one eyeball", "correct": false}, {"label": "C", "text": "Symblepharon", "correct": false}, {"label": "D", "text": "Iridodialysis", "correct": true}], "correct_answer": "D. Iridodialysis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - I\n<table style=\"width:100%\">\n<tbody>\n<tr>\n<td>\n<p><span><span><span><strong><span><span><span>Diplopia</span></span></span></strong></span></span></span></p>\n</td>\n<td>\n<p><span><span><span><strong><span><span><span>Causes</span></span></span></strong></span></span></span></p>\n</td>\n</tr>\n<tr>\n<td>\n<p><span><span><span><strong><span><span><span>Binocular diplopia</span></span></span></strong></span></span></span></p>\n</td>\n<td>\n<ul>\n<li><span><span><span><span><span><span>Paralysis or <span class=\"customMeta\" data-dictid=\"fec3fca4a316927771949da843f588\">paresis</span> of the <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> muscles (Commonest cause)</span></span></span></span></span></span></li>\n<li><span><span><span><span><span><span>Displacement of one <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> either due to the <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> in the orbit and the <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> of the <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> wall.</span></span></span></span></span></span></li>\n<li><span><span><span><span><span><span>Mechanical restriction of the <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> movement caused by the thick pterygium, <span class=\"customMeta\" data-dictid=\"1727fa8cc816927771994ad2a947b5\">symblepharon</span> and <span class=\"customMeta\" data-dictid=\"799202e6fe16927772009a1501b0a8\">thyroid</span> ophthalmopathy.</span></span></span></span></span></span></li>\n<li><span><span><span><span><span><span>Deviation of rays of light in one eye as caused by Decentred spectacles.</span></span></span></span></span></span></li>\n<li><span><span><span> <span><span><span>Anisometropia</span></span></span></span></span></span></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td>\n<p><span><span><span><strong><span><span><span>Uniocular diplopia</span></span></span></strong></span></span></span></p>\n</td>\n<td>\n<ul>\n<li><span><span><span><span><span><span>Subluxated clear lens</span></span></span></span></span></span></li>\n<li><span><span><span><span><span><span>Subluxated <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> lens</span></span></span></span></span></span></li>\n<li><span><span><span><span><span><span>Double <span class=\"customMeta\" data-dictid=\"e419fd4e241692777196d038d1b71a\">pupil</span> due to <span class=\"customMeta\" data-dictid=\"488a4efe7d16927771840c9e29f164\">congenital</span> <span class=\"customMeta\" data-dictid=\"50a440f85816927771817d2fe50984\">anomaly</span> or large <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> <span class=\"customMeta\" data-dictid=\"744b697ac31692777190fa2c638b3a\">iridectomy</span> or iridodialysis.</span></span></span></span></span></span></li>\n<li><span><span><span><span><span><span>Incipient cataract</span></span></span></span></span></span></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 50-year-old female patient visits the ophthalmology clinic with complaints of experiencing vertical diplopia while walking downstairs. Upon further inquiry, it is noted that the patient tends to tilt her head to one side in order to alleviate the diplopia. Which cranial nerve palsy should be suspected in this patient?", "options": [{"label": "A", "text": "3rd nerve", "correct": false}, {"label": "B", "text": "6th nerve", "correct": false}, {"label": "C", "text": "7th nerve", "correct": false}, {"label": "D", "text": "4th nerve", "correct": true}], "correct_answer": "D. 4th nerve", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - 4th nerv\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which drug is commonly used for refraction in a child with accommodative squint?", "options": [{"label": "A", "text": "1% Atropine", "correct": true}, {"label": "B", "text": "Cyclopentolate", "correct": false}, {"label": "C", "text": "Tropicamide", "correct": false}, {"label": "D", "text": "Homatropine", "correct": false}], "correct_answer": "A. 1% Atropine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - 1% A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What are the yoke muscles for Levodepression?", "options": [{"label": "A", "text": "LSO and RIR", "correct": false}, {"label": "B", "text": "RSO and LIR", "correct": true}, {"label": "C", "text": "RIO and LIR", "correct": false}, {"label": "D", "text": "LIO and RIR", "correct": false}], "correct_answer": "B. RSO and LIR", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/8XRZKaTgM9oxIkItPifh1715333931.png"], "explanation": "<p>Correct Option B - RSO (Right Superior Oblique) and LIR (Left &lt;span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\"&gt;Inferior&lt;/span&gt; Rectus)\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:578px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Function</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior rectus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inferior rectus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior oblique</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inferior oblique</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Primary</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elevation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Depression</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intorsion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extorsion</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Secondary</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intorsion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extorsion</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Depression</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elevation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tertiary</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abduction</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements is not true in relation to accommodative esotropia?", "options": [{"label": "A", "text": "It is the most common type of squint", "correct": false}, {"label": "B", "text": "Miotics are used as the treatment strategy in the high AC/A ratio", "correct": false}, {"label": "C", "text": "It is associated with high myopia", "correct": true}, {"label": "D", "text": "Refractive type can be fully corrected by use of spectacles", "correct": false}], "correct_answer": "C. It is associated with high myopia", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - It is associated with high\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Yoke muscle of the right lateral rectus in dextroversion is _________________.", "options": [{"label": "A", "text": "Left superior oblique", "correct": false}, {"label": "B", "text": "Left medial rectus", "correct": true}, {"label": "C", "text": "Left inferior rectus", "correct": false}, {"label": "D", "text": "Right superior rectus", "correct": false}], "correct_answer": "B. Left medial rectus", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/Yo2ZYtlWj9ez8Wo7GHEH1715256210.png"], "explanation": "<p>Correct Option B - Left &lt;span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\"&gt;medial&lt;/span&gt; rectu\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What should be the initial course of action for a 2-year-old child displaying inward deviation of both eyes?", "options": [{"label": "A", "text": "Forced ductions test", "correct": false}, {"label": "B", "text": "Examination under anaesthesia", "correct": false}, {"label": "C", "text": "Refractive error testing", "correct": true}, {"label": "D", "text": "Examination of fundus", "correct": false}], "correct_answer": "C. Refractive error testing", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\"&gt;Refractive&lt;/span&gt; error testing\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The center for vertical gaze is________", "options": [{"label": "A", "text": "Pontine Paramedian Reticular formation", "correct": false}, {"label": "B", "text": "Raphe Nuclues", "correct": false}, {"label": "C", "text": "Rostral interstitial nucleus of the medial longitudinal fasciculus", "correct": true}, {"label": "D", "text": "Substantia nigra", "correct": false}], "correct_answer": "C. Rostral interstitial nucleus of the medial longitudinal fasciculus", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option C - &lt;span class=\"customMeta\" data-dictid=\"1f4bb4632d16927771975d96e35378\"&gt;Rostral&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\"&gt;interstitial&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\"&gt;nucleus&lt;/span&gt; of the &lt;span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\"&gt;medial&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"7ba18aa5e616927771918a45051a40\"&gt;longitudinal&lt;/span&gt; fasciculu\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:576px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Gaze</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Center(s) Responsible</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Horizontal gaze</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pons (Paramedian <span class=\"customMeta\" data-dictid=\"a533b2d59f1692777196694dbb1b2a\">pontine</span> <span class=\"customMeta\" data-dictid=\"0b6b1f44cb1692777197afef785626\">reticular</span> formation - PPRF)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vertical gaze</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Midbrain (Rostral <span class=\"customMeta\" data-dictid=\"f46ba26d111692777190def3b1d80a\">interstitial</span> <span class=\"customMeta\" data-dictid=\"ff628904401692777193c8a9f9159e\">nucleus</span> of the <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"7ba18aa5e616927771918a45051a40\">longitudinal</span> <span class=\"customMeta\" data-dictid=\"6f06ed0fab169277720273078a8258\">fasciculus</span> - RiMLF)</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "The following image indicates :", "options": [{"label": "A", "text": "Trochlear nerve palsy", "correct": false}, {"label": "B", "text": "Abducens nerve palsy", "correct": false}, {"label": "C", "text": "Internuclear opthalmoplegia", "correct": false}, {"label": "D", "text": "Oculomotor palsy", "correct": true}], "correct_answer": "D. Oculomotor palsy", "question_images": ["https://image.prepladder.com/content/tNBUTfRFGBlc577Bdxxf1715141546.png"], "explanation_images": [], "explanation": "<p>Correct Option D - Ocu\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements regarding oculomotor nerve palsy is false?", "options": [{"label": "A", "text": "Ptosis", "correct": false}, {"label": "B", "text": "Mid – dilated pupil", "correct": false}, {"label": "C", "text": "Loss of light reflex in the affected eye", "correct": false}, {"label": "D", "text": "Lateral and upward gaze in primary position", "correct": true}], "correct_answer": "D. Lateral and upward gaze in primary position", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - Lateral and upward g\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 36 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. 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This issue has progressively worsened over the past few months, and she has difficulty with close visual tasks. A refractive error of +6.50 D has been identified. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Accommodative refractive esotropia", "correct": true}, {"label": "B", "text": "Accommodative non-refractive esotropia", "correct": false}, {"label": "C", "text": "Accommodative mixed esotropia", "correct": false}, {"label": "D", "text": "Infantile esotropia", "correct": false}], "correct_answer": "A. Accommodative refractive esotropia", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:719px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Accommodative <span class=\"customMeta\" data-dictid=\"cae831e44316927771973fa5e13fd7\">Refractive</span> Esotropia</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Accommodative Non-refractive Esotropia</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Accommodative Mixed Esotropia</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>High <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> (+4 to +7 D)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abnormal large AC/A (accommodative convergence/accommodation) ratio</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Combination of <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> and high AC/ A ratio</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Correction of <span class=\"customMeta\" data-dictid=\"33b2242b9d1692777189c76a31364e\">hypermetropia</span> (spectacles)</p>\n<br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Corrected by <span class=\"customMeta\" data-dictid=\"66a7c6e72416927771837bca9e4b22\">bifocal</span> <span class=\"customMeta\" data-dictid=\"9e8e9086691692777188b5a212bcc7\">glasses</span> with +3 DS added for near vision</li>\n<li>Miotics (Echothiophate)</li>\n<li>Surgery: <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">Bilateral</span> <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> recession</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Surgery: <span class=\"customMeta\" data-dictid=\"625feb7e3a1692777183aa9d923cfd\">Bilateral</span> <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> recession</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/n58BwRjd848GTmPfBNgo1745939617.mp3", "video": ""}, {"text": "A 7-year old child is brought to the clinic by her parents due to concerns about her right eyes appearing misaligned. On examination, her squint remains constant in all directions of gaze. She does not report any diplopia, and there are no limitations in eye movement. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Concomitant squint", "correct": true}, {"label": "B", "text": "Incomitant squint", "correct": false}, {"label": "C", "text": "Paralytic squint", "correct": false}, {"label": "D", "text": "Pseudo-strabismus", "correct": false}], "correct_answer": "A. Concomitant squint", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Xwk2SEVC3lGHQvm6MHWX1746001075.mp3", "video": ""}, {"text": "A 65 year old woman presented to the OPD with her head tilted towards the right side. On examination, she was having left hypertropia which increases on looking right or medially. The muscle which is most likely paralyzed is:", "options": [{"label": "A", "text": "Right superior oblique", "correct": false}, {"label": "B", "text": "Left superior oblique", "correct": true}, {"label": "C", "text": "Right inferior oblique", "correct": false}, {"label": "D", "text": "Left inferior oblique", "correct": false}], "correct_answer": "B. Left superior oblique", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/x2AYrGPSwmB6hbF8vqYU1746000757.mp3", "video": ""}, {"text": "A 40-year-old patient presents for binocular vision assessment. The ophthalmologist performs the Worth’s Four Dot Test. The patient wears red-green glasses and reports seeing three green dots. What does this finding most likely indicate?", "options": [{"label": "A", "text": "Diplopia", "correct": false}, {"label": "B", "text": "Suppression of right eye", "correct": true}, {"label": "C", "text": "Suppression of left eye", "correct": false}, {"label": "D", "text": "Normal binocular vision", "correct": false}], "correct_answer": "B. Suppression of right eye", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/oPx8EYSaCQAum7kF6i7c1743672162.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/PUdLYV7xujb4eYKrJXoX1746000364.mp3", "video": ""}, {"text": "During a Maddox rod test, the patient is asked to view a distant light source. With the Maddox rod placed in front of the right eye, the patient reports seeing a vertical red line to the right of the white light. What type of ocular misalignment does this result suggest?", "options": [{"label": "A", "text": "Esophoria", "correct": true}, {"label": "B", "text": "Exophoria", "correct": false}, {"label": "C", "text": "Right hyperphoria", "correct": false}, {"label": "D", "text": "Left hyperphoria", "correct": false}], "correct_answer": "A. Esophoria", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/QC5oBb43LxF2YfO78rvp1743672226.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Measure the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">Horizontal</span> <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">Deviation</span> with Maddox rod test</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The red lines of the Maddox rod are placed <strong>horizontally </strong>in front of the <strong>right </strong>eye so that a vertical line is formed.</li>\n<li>The patient is then asked whether the <span class=\"customMeta\" data-dictid=\"0949a8457c169277720228f6c5e1a9\">white light</span> is superimposed on the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> red line or not.</li>\n<li>Patient might see the light source right or left to the red line.</li>\n<li>If superimposed - <strong>normal</strong>.</li>\n<li>If the <strong>patient </strong>is seeing the red line to the left of point light: <strong>Exotropia or <span class=\"customMeta\" data-dictid=\"6b4030e51a1692777185c6a9dc95b0\">crossed</span> diplopia</strong> (as image moves inwards, eye moves outwards). <strong>(Option B)</strong></li>\n<li>If the <strong>patient </strong>is seeing the red line to the right of point light: <strong>Esotropia or uncrossed diplopia</strong>. <strong>(Option A)</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Measure the Vertical <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">Deviation</span> with Maddox rod test</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"><br/>\n\t\t\t </td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The red lines of the Maddox rod are placed <strong>vertically </strong>in front of the <strong>right </strong>eye so that a <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> line is formed.</li>\n<li>The patient is then asked whether the <span class=\"customMeta\" data-dictid=\"0949a8457c169277720228f6c5e1a9\">white light</span> is superimposed on the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> red line or not.</li>\n<li>Patient might see the point light source up or down to the <span class=\"customMeta\" data-dictid=\"6f4a4d02ec169277718995b05c1d26\">horizontal</span> line.</li>\n<li>If superimposed - <strong>normal/orthophoria</strong>.</li>\n<li>If the point light source is <strong>above </strong>the red line: <strong>right <span class=\"customMeta\" data-dictid=\"68c6b2e495169277718909762db6d8\">hyperphoria</span> </strong>or <strong>left hypophoria</strong>. <strong>(Option C)</strong></li>\n<li>If the point light source is <strong>below</strong> the red line: <strong>right <span class=\"customMeta\" data-dictid=\"e9fdcb366d1692777189d47997b939\">hypophoria</span> </strong>or <strong>left hyperphoria</strong>. <strong>(Option D)</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/UEBfl5QvURgxty44FeWH1745999919.mp3", "video": ""}, {"text": "A 45-year-old male presents with eyelid retraction on downgaze. He has a history of ocular nerve injury. Which of the following best describes this condition?", "options": [{"label": "A", "text": "Von Graefe’s Sign", "correct": false}, {"label": "B", "text": "Hutchinson’s Pupil", "correct": false}, {"label": "C", "text": "Pseudo-Von Graefe Sign", "correct": true}, {"label": "D", "text": "Marcus Gunn Jaw-Winking Phenomenon", "correct": false}], "correct_answer": "C. Pseudo-Von Graefe Sign", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/4d3cTNgWRpWYsUUxiYEj1743674281.png", "https://image.prepladder.com/notes/duYInowPp6cS9huTBH7E1743674282.png", "https://image.prepladder.com/notes/a3ha5yOWSrbhiaQudcLV1743674283.png"], "explanation": "<p><strong>References:</strong></p>\n<ul><li>↳ Reference:</li></u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MMFK7f6Z0dUXiwlXUNFO1745999718.mp3", "video": ""}, {"text": "A 7-year-old girl has limited abduction of the left eye, with globe retraction and narrowing of the palpebral fissure on adduction and widening of the fissure on attempted abduction. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Duane Retraction Syndrome Type I", "correct": true}, {"label": "B", "text": "Duane Retraction Syndrome Type II", "correct": false}, {"label": "C", "text": "Duane Retraction Syndrome Type III", "correct": false}, {"label": "D", "text": "Sixth Cranial Nerve Palsy", "correct": false}], "correct_answer": "A. Duane Retraction Syndrome Type I", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type I</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type II</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type III</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limited</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limited</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Normal or mildly limited</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limited</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Limited</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Globe Retraction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present on adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Variable</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Present on adduction</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Palpebral <span class=\"customMeta\" data-dictid=\"b2af124a931692777203c9f8031b77\">Fissure</span> on Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Narrows</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slight change</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Narrows</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Palpebral <span class=\"customMeta\" data-dictid=\"b2af124a931692777203c9f8031b77\">Fissure</span> on Abduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Widens</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>No significant change</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Slight change</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Pathophysiology</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Absent CN VI; CN III innervates LR</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>CN III innervates LR</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Co-contraction of LR and MR</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/leAGQyqhFrfmsMhM0gEI1745999060.mp3", "video": ""}, {"text": "A 60-year-old patient presents with the following symptoms: right-sided facial weakness, right-sided lateral gaze impairment, and weakness on the left side of the body. Imaging reveals a ventral pontine lesion. Which of the following syndromes best describes this patient's condition?", "options": [{"label": "A", "text": "Gradenigo Syndrome", "correct": false}, {"label": "B", "text": "Millard-Gubler Syndrome", "correct": true}, {"label": "C", "text": "Moebius Syndrome", "correct": false}, {"label": "D", "text": "Foville Syndrome", "correct": false}], "correct_answer": "B. Millard-Gubler Syndrome", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:644px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Syndromes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Foville Syndrome</strong></p>\n<p><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Damage to the <span class=\"customMeta\" data-dictid=\"51b29c48291692777186b488ac8cd9\">dorsal</span> <span class=\"customMeta\" data-dictid=\"a533b2d59f1692777196694dbb1b2a\">pontine</span> area affects the <span class=\"customMeta\" data-dictid=\"493415137f1692777180adce8b5447\">abducens</span> nucleus, <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> nucleus, and <span class=\"customMeta\" data-dictid=\"0cf8ac70611692777186b133d027f6\">descending</span> <span class=\"customMeta\" data-dictid=\"a218fdbabf1692777185a2d48a9e1c\">corticospinal</span> fibres.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Sixth Nerve Palsy</strong></li>\n<li><strong>Seventh Nerve Palsy</strong></li>\n<li><strong>Contralateral Hemiparesis</strong></li>\n<li><strong>Central Horner Syndrome</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Millard-Gubler Syndrome</strong></p>\n<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ventral <span class=\"customMeta\" data-dictid=\"a533b2d59f1692777196694dbb1b2a\">pontine</span> injury affects the <span class=\"customMeta\" data-dictid=\"493415137f1692777180adce8b5447\">abducens</span> nerve <span class=\"customMeta\" data-dictid=\"b17785d7c7169277720246b0430877\">fascicle</span> and <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> nerve fibres.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Lateral <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">Rectus</span> Weakness</strong></li>\n<li><strong>Ipsilateral <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> paralysis</strong></li>\n<li><strong>Contralateral Hemiparesis</strong></li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Moebius Syndrome</strong></p>\n<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Congenital condition affecting <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve development.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Facial Nerve Palsy</strong></li>\n<li><strong>Eye Movement Abnormalities</strong>: The eyes may exhibit <span class=\"customMeta\" data-dictid=\"fab38cc27d1692777187428fc9b37f\">esotropia</span> (inward turning) or <span class=\"customMeta\" data-dictid=\"0281e1289a169277718712867d6226\">exotropia</span> (outward turning).</li>\n<li><strong>Orofacial Dysmorphism</strong>: Abnormalities in <span class=\"customMeta\" data-dictid=\"9fdd7489051692777202cffe3f24cc\">facial</span> structure, which may include difficulty with suckling and <span class=\"customMeta\" data-dictid=\"4af22cd2a8169277719558b4bb23fc\">phonation</span> in infants.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Gradenigo Syndrome</strong></p>\n<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mastoiditis leads to infection and <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> near the <span class=\"customMeta\" data-dictid=\"88225eeb1616927771954c1b0bc1e3\">petrous</span> <span class=\"customMeta\" data-dictid=\"2d7ea2751316927771816ceb31afee\">apex</span> of the <span class=\"customMeta\" data-dictid=\"637ea4d17516927772003be2b2aae4\">temporal</span> bone.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Abducens Nerve Palsy</strong>: Difficulty moving the eye laterally, often associated with pain.</li>\n<li><strong>Facial Pain</strong>: Pain may be present due to involvement of the <span class=\"customMeta\" data-dictid=\"6d1eb38ecf1692777200bb65bbdefb\">trigeminal</span> nerve.</li>\n<li><strong>Deafness</strong>: Associated with mastoiditis, which results in pain and deafness.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/jC1xnciIcpuZU8mPSYo71745998829.mp3", "video": ""}, {"text": "A 45-year-old man has double vision and an inward deviation of his left eye. On examination it is found to be associated with 6th Cranial Nerve Palsy. What finding is typical for sixth cranial nerve palsy?", "options": [{"label": "A", "text": "Vertical diplopia", "correct": false}, {"label": "B", "text": "Pupils are affected", "correct": false}, {"label": "C", "text": "Head turn towards the same side, avoiding diplopia", "correct": true}, {"label": "D", "text": "Crossed Diplopia", "correct": false}], "correct_answer": "C. Head turn towards the same side, avoiding diplopia", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/CTwxc0WKfquSpHZzTSES1745998555.mp3", "video": ""}, {"text": "A 45-year-old patient reports diplopia and is found to have left trochlear nerve palsy. Which of the following findings is not typically associated with it?", "options": [{"label": "A", "text": "Diplopia relieves while going downstairs", "correct": true}, {"label": "B", "text": "No diplopia with head tilt away from the left side", "correct": false}, {"label": "C", "text": "Hypertropia of the affected eye", "correct": false}, {"label": "D", "text": "Increase in hypertropia on opposite gaze", "correct": false}], "correct_answer": "A. Diplopia relieves while going downstairs", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/pLvjCT9xeJUyot3kXwDg1743673738.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HLZIeCnPqoDnzrKhZAvm1745940894.mp3", "video": ""}, {"text": "A 65-year-old patient presents with the following findings. Which of the following is least likely to be associated with this condition?", "options": [{"label": "A", "text": "Weber's Syndrome", "correct": false}, {"label": "B", "text": "Benedict's Syndrome", "correct": false}, {"label": "C", "text": "Nothmagel's Syndrome", "correct": false}, {"label": "D", "text": "Brown's Syndrome", "correct": true}], "correct_answer": "D. Brown's Syndrome", "question_images": ["https://image.prepladder.com/notes/rQ2sp8OH3crq6L2WJDR61743673683.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cause</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Weber's Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Injury to cerebral peduncle.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Third nerve <span class=\"customMeta\" data-dictid=\"f3e67cebd51692777194f5257898e4\">palsy</span> on the same side (ipsilateral) as the affected eye, combined with <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> <span class=\"customMeta\" data-dictid=\"4e69f1c7691692777188a80c8ffd0d\">hemiplegia</span> (paralysis on the opposite side of the body).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Benedict's Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Injury to the Red nucleus</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Third nerve <span class=\"customMeta\" data-dictid=\"f3e67cebd51692777194f5257898e4\">palsy</span> with <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> hemi-tremors, <span class=\"customMeta\" data-dictid=\"46ce506e9d1692777184f7a4a276ad\">chorea</span> &amp; athetosis.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Nothnagel's Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Injury to the Superior Cerebellar Peduncle</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Third nerve <span class=\"customMeta\" data-dictid=\"f3e67cebd51692777194f5257898e4\">palsy</span> with <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">ipsilateral</span> cerebellar <span class=\"customMeta\" data-dictid=\"0842a8a59f1692777182f44d334dda\">ataxia</span> (balance and <span class=\"customMeta\" data-dictid=\"3820ba101416927771858fe257e119\">coordination</span> problems on the same side as the affected eye).</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Claude's Syndrome</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Lesion in the <span class=\"customMeta\" data-dictid=\"d26464df7216927771923483619265\">midbrain</span> affects both the <span class=\"customMeta\" data-dictid=\"ae7e8fa7d31692777194e3d4325f6b\">oculomotor</span> nerve (CN III) and the red nucleus.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Third nerve palsy, <span class=\"customMeta\" data-dictid=\"ca762506461692777190f12b43bb1a\">ipsilateral</span> cerebellar ataxia, and <span class=\"customMeta\" data-dictid=\"1a5d9f72801692777185eb596f3d64\">contralateral</span> hemi-tremors.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/K4OiHKiqiQA9q4x8TQOD1745940538.mp3", "video": ""}, {"text": "A 60-year-old man presents with sudden onset double vision and difficulty aligning his eyes, which began three weeks ago. He has a history of hypertension and recently experienced a mild stroke. Examination reveals that his eye is positioned downward and outward. Which of the following statements about this condition is incorrect?", "options": [{"label": "A", "text": "Ptosis is present", "correct": false}, {"label": "B", "text": "Mydriasis is present", "correct": false}, {"label": "C", "text": "Pupil is fixed", "correct": false}, {"label": "D", "text": "Accommodation increases", "correct": true}], "correct_answer": "D. Accommodation increases", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/XHZUIFFhNl9lleBitr3G1743664708.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/k0ocJJ5j6rZBecx7XSdJ1745940337.mp3", "video": ""}, {"text": "How much is the difference in deviation between upward gaze and downward gaze in A-V pattern strabismus?", "options": [{"label": "A", "text": "A-pattern ≥ 10 PD, V-pattern ≥ 15 PD", "correct": true}, {"label": "B", "text": "A-pattern ≥ 15 PD, V-pattern ≥ 10 PD", "correct": false}, {"label": "C", "text": "A-pattern ≤ 10 PD, V-pattern ≤ 15 PD", "correct": false}, {"label": "D", "text": "A-pattern ≤ 15 PD, V-pattern ≤ 10 PD", "correct": false}], "correct_answer": "A. A-pattern ≥ 10 PD, V-pattern ≥ 15 PD", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/zdDIATsBLzgQYkCS29tx1743673585.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Amount of <span class=\"customMeta\" data-dictid=\"fa328dbc09169277718631e23a772f\">deviation</span> </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>‘A’ pattern</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>‘V’ pattern</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Between upward and downward gaze</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>≥ 10 PD or <span class=\"customMeta\" data-dictid=\"6bb8c041fd169277719626a00309b1\">prism</span> dioptre</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>≥ 15 PD or <span class=\"customMeta\" data-dictid=\"6bb8c041fd169277719626a00309b1\">prism</span> dioptre</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esotropia (in upward gaze)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Esotropia (in downward gaze)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exotropia (in upward gaze)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Exotropia (in downward gaze) </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Increases</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Decreases</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/1XOLKmyzQp3MDEup8HVM1745939993.mp3", "video": ""}, {"text": "A 45-year-old male complains of double vision, describing seeing two overlapping images when looking in a specific direction. He reports that this problem started suddenly about two weeks ago and is most noticeable when looking towards the right side. There is no history of trauma. On examination, he has limited movement of the right eye towards the right. What is the most likely cause of this condition?", "options": [{"label": "A", "text": "Blowout fracture", "correct": false}, {"label": "B", "text": "Thick pterygium", "correct": false}, {"label": "C", "text": "Subluxation of lens", "correct": false}, {"label": "D", "text": "Paralytic strabismus", "correct": true}], "correct_answer": "D. Paralytic strabismus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/LoN5lQ3sbkQ3CleQYn2j1743673080.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:618px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Uniocular diplopia</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Binocular diplopia</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Subluxation of lens <strong>(Option C)</strong></li>\n<li>Polycoria (multiple pupils)</li>\n<li>Incipient cataract</li>\n<li>Keratoconus</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Paralysis of <span class=\"customMeta\" data-dictid=\"7d57c304c01692777187da125d18d8\">extraocular</span> muscles (e.g. <span class=\"customMeta\" data-dictid=\"14bba9af561692777194c8cadacf13\">paralytic</span> strabismus) <strong>(Option D)</strong></li>\n<li>Orbital lesions</li>\n<li>Orbital fractures (e.g. blowout fracture) <strong>(Option A)</strong></li>\n<li>Thick <span class=\"customMeta\" data-dictid=\"9571debfbe1692777196de3e804df2\">pterygium</span> <strong>(Option B)</strong></li>\n<li>Symblepharon</li>\n<li>Thyroid ophthalmopathy</li>\n<li>Decentred spectacles</li>\n<li>Anisometropia</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/yZXyyh5kGxgOh1tUo6Mt1745939767.mp3", "video": ""}, {"text": "Which of the following is known for its specific pattern of muscle insertions around the sclera, essential for the alignment and movement of the extraocular muscles?", "options": [{"label": "A", "text": "Annulus of Zinn", "correct": false}, {"label": "B", "text": "Spiral of Tillaux", "correct": true}, {"label": "C", "text": "Scleral spur", "correct": false}, {"label": "D", "text": "Tenon’s capsule", "correct": false}], "correct_answer": "B. Spiral of Tillaux", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/i3OfD9hpdDRcL6xq0kOv1743671434.png", "https://image.prepladder.com/notes/BbxHlIaQx2vzXpr09B9C1743671435.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:585px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medial Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inserts closest to the limbus, about <strong>5.5 mm</strong> from the limbus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inserts <strong>6.5 mm</strong> from the limbus.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inserts <strong>6.9 mm</strong> from the limbus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inserts the farthest, about <strong>7.7 mm</strong> from the limbus.</p>\n</td>\n</tr>\n</tbody>\n\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Ti7czRgFyH5zcw2P8HHC1745935480.mp3", "video": ""}, {"text": "A 10-year-old child is having trouble catching a ball, climbing stairs, and performing fine motor tasks. She has a tendency to avoid activities requiring precise hand skills. No developmental delay was detected. Which of the following tests would be appropriate for diagnosing her condition?", "options": [{"label": "A", "text": "HESS chart", "correct": false}, {"label": "B", "text": "Cover-uncover test", "correct": false}, {"label": "C", "text": "Titmus fly test", "correct": true}, {"label": "D", "text": "Maddox rod test", "correct": false}], "correct_answer": "C. Titmus fly test", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/mIPWBUHf75TPhjAq8C4I1743672947.png", "https://image.prepladder.com/notes/MxQv4KPSP223tYeiWKT61743672948.png", "https://image.prepladder.com/notes/TNMh8DBf2XmZg87pF20z1743671943.png", "https://image.prepladder.com/notes/QC5oBb43LxF2YfO78rvp1743672226.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/uLmX3p7T99dN1H10Ivpz1745939387.mp3", "video": ""}, {"text": "The parents of an 8-month-old girl have observed her eyes misaligning, especially when she focuses on objects up close, with one eye occasionally turning inward. They consulted an ophthalmologist, who conducted the test shown below. What is the name of this test?", "options": [{"label": "A", "text": "Hirschberg test", "correct": false}, {"label": "B", "text": "Bruckner test", "correct": true}, {"label": "C", "text": "Prism cover test", "correct": false}, {"label": "D", "text": "Krimsky test", "correct": false}], "correct_answer": "B. Bruckner test", "question_images": ["https://image.prepladder.com/notes/DdNh4Nr7Xc2v40h8D5AL1743672656.png"], "explanation_images": ["https://image.prepladder.com/notes/DdNh4Nr7Xc2v40h8D5AL1743672656.png", "https://image.prepladder.com/notes/BzAQTNkuY1quMcnRyA6i1743672406.png", "https://image.prepladder.com/notes/uY2Ib2xJBfAbTXU1fmAJ1743672660.png", "https://image.prepladder.com/notes/HVxjZHec4YTIcxrwOAre1743672663.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2DSqpDwKkFSjHJTK5kpg1745939050.mp3", "video": ""}, {"text": "A 10-year-old boy's parents noticed his left eye turning inward, especially when tired or focusing on near objects. An ophthalmologist diagnosed strabismus and performed the test shown below. Which statements about this test are correct?", "options": [{"label": "A", "text": "It indicates the angle of squint", "correct": false}, {"label": "B", "text": "In an aligned eye, the reflex is centred", "correct": false}, {"label": "C", "text": "Reflex at limbus indicates 45° squint", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": ["https://image.prepladder.com/notes/WZbXBGrbWx9kAgh0iBS21743672399.png"], "explanation_images": ["https://image.prepladder.com/notes/Wpibrzz0bISdX7U1tZq91743672402.png", "https://image.prepladder.com/notes/BzAQTNkuY1quMcnRyA6i1743672406.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/5fNl8Oi3IsSG2q9m9QeL1745938589.mp3", "video": ""}, {"text": "A 32-year-old patient presents with eye strain and headaches. The ophthalmologist plans to perform a series of tests to evaluate the patient’s strabismus. All of the following are objective tests used to assess strabismus except?", "options": [{"label": "A", "text": "Maddox Rod test", "correct": true}, {"label": "B", "text": "Prism Bar Cover test", "correct": false}, {"label": "C", "text": "Cover Uncover test", "correct": false}, {"label": "D", "text": "Hirschberg test", "correct": false}], "correct_answer": "A. Maddox Rod test", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/QC5oBb43LxF2YfO78rvp1743672226.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:582px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Objective Tests</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Subjective Tests</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Corneal Light <span class=\"customMeta\" data-dictid=\"20f478f55f1692777197e351415f8f\">Reflex</span> Test (Hirschberg Test, Krimsky Test)</li>\n<li>Bruckner Test</li>\n<li>Cover-Uncover Test</li>\n<li>Prism Bar Test</li>\n<li>Synoptophore</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Maddox Rod Test</li>\n<li>Maddox Wing Test</li>\n<li>Lancaster Red-Green Test</li>\n<li>Hess Screen</li>\n<li>Haploscopic Devices (Major Amblyoscope)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ndqIX5kWEMu4YlaaiJ341745938110.mp3", "video": ""}, {"text": "A 35-year-old patient presents with increased diplopia on upward gaze and restricted movement of the left eye. The patient also has a history of recent orbital trauma. To determine whether the limitation is due to a mechanical restriction or a nerve palsy, which of the following tests is most appropriate?", "options": [{"label": "A", "text": "Hess screen test", "correct": false}, {"label": "B", "text": "Forced duction test", "correct": true}, {"label": "C", "text": "Cover test", "correct": false}, {"label": "D", "text": "Worth’s 4-dot test", "correct": false}], "correct_answer": "B. Forced duction test", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/HLySNtkR56UX8ZOUIQH31743671944.png", "https://image.prepladder.com/notes/z60Uey8RTNDEEA4ALa1R1743672161.png", "https://image.prepladder.com/notes/TNMh8DBf2XmZg87pF20z1743671943.png", "https://image.prepladder.com/notes/oPx8EYSaCQAum7kF6i7c1743672162.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3OoOcocbQs11vA6E7SmX1745937763.mp3", "video": ""}, {"text": "A 10-year-old patient presents to the clinic with complaints of occasional double vision and eye strain during schoolwork. On examination, you suspect she may have a squint and perform the following test. What is this test known as?", "options": [{"label": "A", "text": "Maddox Rod Test", "correct": false}, {"label": "B", "text": "Synoptophore", "correct": false}, {"label": "C", "text": "Cover-Uncover Test", "correct": true}, {"label": "D", "text": "Maddox Wing Test", "correct": false}], "correct_answer": "C. Cover-Uncover Test", "question_images": ["https://image.prepladder.com/notes/TNMh8DBf2XmZg87pF20z1743671943.png"], "explanation_images": ["https://image.prepladder.com/notes/TNMh8DBf2XmZg87pF20z1743671943.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kabkYiPinaoM8NEeNkrK1745937347.mp3", "video": ""}, {"text": "Which of the following options correctly identifies the type of strabismus depicted in each image? 1. 2. 3.", "options": [{"label": "A", "text": "1- Esotropia; 2-Exotropia; 3-Hypotropia", "correct": false}, {"label": "B", "text": "1- Esotropia; 2-Hypertropia; 3- Exotropia", "correct": false}, {"label": "C", "text": "1- Hypertropia; 2-Exotropia; 3-Hypotropia", "correct": false}, {"label": "D", "text": "1- Hypertropia; 2-Esotropia; 3-Exotropia", "correct": true}], "correct_answer": "D. 1- Hypertropia; 2-Esotropia; 3-Exotropia", "question_images": ["https://image.prepladder.com/notes/VVySjLhG4ElBwnhGqmd41743671709.png", "https://image.prepladder.com/notes/SrO3sUXm0XIWSgOb26S61743671709.png", "https://image.prepladder.com/notes/oxcSq8g5lmzxsOxJDiMj1743671709.png"], "explanation_images": ["https://image.prepladder.com/notes/9QpPTw2EoqZ08sEZC8Q41743671710.png", "https://image.prepladder.com/notes/YAWJlKSjlbjwf6D2Uugd1743671710.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:550px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Feature</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Incomitant Strabismus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p><strong>Concomitant Strabismus</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Magnitude of Squint</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Varies with eye position</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Same in all positions</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Diplopia</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Present</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Absent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>False Projection</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Present</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Absent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Abnormal Head Posture</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Present</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Absent</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Secondary Deviation</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Secondary &gt; Primary</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Secondary = Primary</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Ocular Movements</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Restricted</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:bottom\">\n<p>Full</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/KOJViLsnmxzNzWYYoAFF1745937057.mp3", "video": ""}, {"text": "Which mechanism is responsible for maintaining coordinated movement of both eyes and achieving binocular vision?", "options": [{"label": "A", "text": "Conjugate and Dysconjugate movements", "correct": false}, {"label": "B", "text": "Synergistic and Antagonistic muscles", "correct": false}, {"label": "C", "text": "Yoke muscles", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Conjugate &amp; Dysconjugate Movements</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Synkinesis</strong> refers to the simultaneous movement of both eyes in the same direction, essential for maintaining <span class=\"customMeta\" data-dictid=\"eadd1d717a16927771833964224058\">binocular</span> alignment.\n\t\t\t\t<ul>\n<li>This is known as<strong> <span class=\"customMeta\" data-dictid=\"2421c657771692777185af1b7b59c3\">conjugate</span> movement</strong>.</li>\n</ul>\n</li>\n<li><strong>Dysconjugate movements</strong> occur when the eyes move in opposite directions, such as during <span class=\"customMeta\" data-dictid=\"f7bc6be47c1692777185caa5f693ce\">convergence</span> (both eyes move inward) or <span class=\"customMeta\" data-dictid=\"9e1f577dad16927771863e4feb90a8\">divergence</span> (both eyes move outward).</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Synergistic &amp; Antagonistic Muscles</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Synergistic muscles</strong> <strong>contract together</strong> to move both eyes in a specific direction.\n\t\t\t\t<ul>\n<li>Eg: In <span class=\"customMeta\" data-dictid=\"d2b8bb12121692777186ca088f5070\">Dextroversion</span> (rightward gaze), the right <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> and left <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> act as synergists.</li>\n</ul>\n</li>\n<li><strong>Antagonistic muscles</strong> are those that <strong>relax</strong> or are inhibited during these movements.\n\t\t\t\t<ul>\n<li>Eg: In Dextroversion, the right <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> and left <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> are antagonists.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Yoke Muscles</strong></p>\n\t\t\t \n\n\t\t\t<p><strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Yoke muscles</strong> are pairs of <span class=\"customMeta\" data-dictid=\"2aa3c660ae1692777199bc1c269f31\">synergistic</span> muscles in each eye that work together to achieve coordinated eye movements.</p>\n<ul>\n<li>Eg: In the Rightward gaze, the right <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">lateral</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> and left <span class=\"customMeta\" data-dictid=\"db46007ad21692777192dcc160a2e2\">medial</span> <span class=\"customMeta\" data-dictid=\"53951671cd16927771971ed604bcf4\">rectus</span> are <span class=\"customMeta\" data-dictid=\"c473a9095b16927772021aeb561d33\">yoke</span> muscles that contract together to move the eyes in the same direction.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Neurological Control</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Hering's Law of Equal Innervation</strong> ensures that both eyes receive equal and simultaneous <span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\">neural</span> input to the <span class=\"customMeta\" data-dictid=\"2aa3c660ae1692777199bc1c269f31\">synergistic</span> (yoke) muscles during <span class=\"customMeta\" data-dictid=\"2421c657771692777185af1b7b59c3\">conjugate</span> movements.</li>\n<li><strong>Sherrington's Law of <span class=\"customMeta\" data-dictid=\"5afb1c86751692777197cf9452d41b\">Reciprocal</span> Innervation</strong> states that increased <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of a muscle is accompanied by decreased <span class=\"customMeta\" data-dictid=\"ba6b77f29316927771807350f86ce2\">activation</span> of its direct <span class=\"customMeta\" data-dictid=\"2e432a4f3c1692777181e8e244ca0e\">antagonist</span> muscle.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ocular Motor <span class=\"customMeta\" data-dictid=\"e6b47028191692777193eb698e43b6\">Nuclei</span> and Pathways</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The control of eye movements involves several <span class=\"customMeta\" data-dictid=\"4004f1f7241692777183d200f866da\">brainstem</span> nuclei, including the <strong>oculomotor (III)</strong>, <strong>trochlear (IV)</strong>, and <strong>abducens (VI)</strong> nuclei.</li>\n<li>These <span class=\"customMeta\" data-dictid=\"e6b47028191692777193eb698e43b6\">nuclei</span> coordinate eye movements through <span class=\"customMeta\" data-dictid=\"b00388be25169277719369b3ab059f\">neural</span> pathways, such as the <strong>medial <span class=\"customMeta\" data-dictid=\"7ba18aa5e616927771918a45051a40\">longitudinal</span> <span class=\"customMeta\" data-dictid=\"6f06ed0fab169277720273078a8258\">fasciculus</span> (MLF)</strong>, which connects various eye movement centres.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/JdYRvHciAtO1fKPH2D181745936853.mp3", "video": ""}, {"text": "A 32-year-old patient presents with diplopia and difficulty looking upwards and to the right, with limited elevation of the right eye. You suspect a lesion affecting a muscle responsible for vertical movement. Which axis describes the rotational movement, and which muscle is likely affected?", "options": [{"label": "A", "text": "Fick's x-axis; Right Inferior Rectus", "correct": false}, {"label": "B", "text": "Fick's y-axis; Right Medial Rectus", "correct": false}, {"label": "C", "text": "Fick's z-axis; Right Inferior Oblique", "correct": false}, {"label": "D", "text": "Fick's x-axis; Right Superior Rectus", "correct": true}], "correct_answer": "D. Fick's x-axis; Right Superior Rectus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/em7ENC5cSawzFPew0WD21743671587.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Axis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Direction</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Movements</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Muscles Involved</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>X-Axis (Horizontal)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Runs horizontally from the outer corner to the inner corner.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Elevation</strong> (upward) and <strong>Depression</strong> (downward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior Rectus, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">Inferior</span> Rectus</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Y-Axis (Anteroposterior)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Runs anteroposteriorly from the front (cornea) to the back.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Intorsion</strong> (inward rotation) and <strong>Extorsion</strong> (outward rotation)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Superior Oblique, <span class=\"customMeta\" data-dictid=\"49c4ef5b9d1692777190c0277f8344\">Inferior</span> Oblique</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Z-Axis (Vertical)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Runs vertically from the top of the head to the chin.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Adduction</strong> (inward) and <strong>Abduction</strong> (outward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Medial Rectus, <span class=\"customMeta\" data-dictid=\"fc380e21321692777191739bd99191\">Lateral</span> Rectus</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/WePZ8W4KSVld5rxN5yau1745936401.mp3", "video": ""}, {"text": "Which physiological principle explains that during eye movement, an increase in neural stimulation to a contracting muscle is accompanied by a proportional decrease in stimulation to its opposing muscle?", "options": [{"label": "A", "text": "Hering’s Law", "correct": false}, {"label": "B", "text": "Sherrington’s Law", "correct": true}, {"label": "C", "text": "Henle’s Law", "correct": false}, {"label": "D", "text": "Donder’s Law", "correct": false}], "correct_answer": "B. Sherrington’s Law", "question_images": [], "explanation_images": [], "explanation": "<p><strong>References:</strong></p>\n<ul><li>↳ Reference:</li></u\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/17ZybG9Qe0IcJG0tcu1k1745936036.mp3", "video": ""}, {"text": "A 25-year-old patient presents with a condition in which, upon examination, the left eye fails to adduct during right gaze. The patient reports diplopia, which is more noticeable when looking to the right. Which extraocular muscle is most likely overacting in this patient's condition?", "options": [{"label": "A", "text": "Right Medial Rectus", "correct": false}, {"label": "B", "text": "Left Lateral Rectus", "correct": false}, {"label": "C", "text": "Right Lateral Rectus", "correct": true}, {"label": "D", "text": "Left Medial Rectus", "correct": false}], "correct_answer": "C. Right Lateral Rectus", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/KT0YM7w1b4lF7tIEMEFR1743671518.png", "https://image.prepladder.com/notes/mvnTE6hlujQm3Nscllv31743671519.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/4RG2DlwpdlirSUeYRNO21745935767.mp3", "video": ""}, {"text": "A 45-year-old patient presents with vertical diplopia that worsens when looking down, especially while walking downstairs. Examination reveals weakness in intorsion, depression, and abduction of the affected eye. Which muscle and cranial nerve are most likely affected?", "options": [{"label": "A", "text": "Superior Rectus; CN III", "correct": false}, {"label": "B", "text": "Inferior Oblique; CN III", "correct": false}, {"label": "C", "text": "Superior Oblique; CN IV", "correct": true}, {"label": "D", "text": "Inferior Rectus; CN IV", "correct": false}], "correct_answer": "C. Superior Oblique; CN IV", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:685px\">\n<tbody>\n<tr>\n<td colspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Extraocular muscles and actions</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Muscle</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Primary Action</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Secondary Actions</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Innervation</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Medial Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Adduction (moves eye inward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Oculomotor nerve (CN III)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Lateral Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abduction (moves eye outward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>None</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Abducens nerve (CN VI)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elevation (moves eye upward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intorsion (inward rotation), Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (CN III)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior Rectus</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Depression (moves eye downward)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extorsion (outward rotation), Adduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (CN III)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Superior Oblique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intorsion (inward rotation)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Depression, Abduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Trochlear nerve (CN IV)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Inferior Oblique</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Extorsion (outward rotation)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Elevation, Abduction</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Oculomotor nerve (CN III)</strong></p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/83VmJa7wXuHQJAFr4fQ71745223197.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 37 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient presents with sudden diminution of vision, difficulty looking towards the light, and circumcorneal congestion with a hypopyon. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Acute conjunctivitis", "correct": false}, {"label": "B", "text": "Acute angle closure glaucoma", "correct": false}, {"label": "C", "text": "Episcleritis", "correct": false}, {"label": "D", "text": "Acute anterior uveitis", "correct": true}], "correct_answer": "D. Acute anterior uveitis", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option D - &lt;span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\"&gt;Acute&lt;/span&gt; &lt;span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\"&gt;anterior&lt;/span&gt; uv\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 32-year-old patient presents with blurred vision, photophobia, and mild ocular pain. Examination reveals aqueous flares and keratic precipitates in the anterior chamber. What is the likely diagnosis?", "options": [{"label": "A", "text": "Intermediate uveitis", "correct": false}, {"label": "B", "text": "Posterior uveitis", "correct": false}, {"label": "C", "text": "Toxoplasma uveitis", "correct": false}, {"label": "D", "text": "Iridocyclitis", "correct": true}], "correct_answer": "D. Iridocyclitis", "question_images": [], "explanation_images": [], "explanation": "<table align=\"center\" cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Type of Uveitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Anterior <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Granulomatous iridocyclitis</strong>, <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> nodules, large mutton fat KPs, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber cells and flare, <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> synechiae</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Intermediate <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Vitreous cells, snowball opacities, snowbanking</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Posterior <strong>(Option B)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Choroidal and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> granulomas, <span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\">cystoid</span> <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, <span class=\"customMeta\" data-dictid=\"bd07bff8e716927771956e7a57bd70\">periphlebitis</span> retinae with candle <span class=\"customMeta\" data-dictid=\"9eae373ada1692777202074bbc0222\">wax</span> droppings appearance</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Peripheral Multifocal Chorioretinitis</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Small, <span class=\"customMeta\" data-dictid=\"7134f7f8681692777196fa644c43bf\">punched-out</span> atrophic spots, highly suggestive of sarcoidosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Uveoparotid Fever (Heerfordt’s Syndrome)</p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Bilateral <span class=\"customMeta\" data-dictid=\"9e1f97f6ad169277718805c2dd35c1\">granulomatous</span> panuveitis, painful <span class=\"customMeta\" data-dictid=\"42d0553c3916927771944110a6f15b\">parotid</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> enlargement, <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve palsies, skin rashes, fever, malaise</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Iritis is least associated with all of the following diseases:", "options": [{"label": "A", "text": "Systemic Lupus Erythematosus", "correct": true}, {"label": "B", "text": "Behcet's Disease", "correct": false}, {"label": "C", "text": "Psoriatic Arthropathy", "correct": false}, {"label": "D", "text": "Ulcerative colitis", "correct": false}], "correct_answer": "A. Systemic Lupus Erythematosus", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A farmer presents with pain and discharge in his left eye. He says that he sustained an injury caused by a leaf a few days back. What is the finding seen in the image?", "options": [{"label": "A", "text": "Hyphema", "correct": false}, {"label": "B", "text": "Aqueous flare", "correct": false}, {"label": "C", "text": "Arlt line", "correct": false}, {"label": "D", "text": "Hypopyon", "correct": true}], "correct_answer": "D. Hypopyon", "question_images": ["https://image.prepladder.com/notes/lzl2H1Qbg6vb0Ydzdnpy1746698628.png"], "explanation_images": ["https://image.prepladder.com/notes/u5bydeu6D4eMjnxvwkxg1745324264.png", "https://image.prepladder.com/notes/lzl2H1Qbg6vb0Ydzdnpy1746698628.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Iritis is not seen in: Rheumatoid arthritis SLE Bechet’s disease Psoriatic arthritis Ulcerative colitis", "options": [{"label": "A", "text": "1 and 2", "correct": true}, {"label": "B", "text": "1,2,3 and 4", "correct": false}, {"label": "C", "text": "2,4 and 5", "correct": false}, {"label": "D", "text": "1,3 and 4", "correct": false}], "correct_answer": "A. 1 and 2", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 26-year-old patient came with complaints of blurring of vision, photophobia, redness, pain in the left eye, and joint pain. Upon examination keratic precipitates and aqueous cells were observed. Which of the following major histocompatibility complex is be associated with this condition?", "options": [{"label": "A", "text": "HLA B27", "correct": true}, {"label": "B", "text": "HLA B51", "correct": false}, {"label": "C", "text": "HLA B47", "correct": false}, {"label": "D", "text": "HLA B57", "correct": false}], "correct_answer": "A. HLA B27", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/7IH1iTlsFKo7Cql1Py0j1746700076.png", "https://image.prepladder.com/content/Cut7rBJVLym6tQnljMmR1746700088.png", "https://image.prepladder.com/content/ws50joqXNmytMvBmoCqJ1746700101.png", "https://image.prepladder.com/content/bwdRrUJ2AUDMsnR3kPwq1746700113.png", "https://image.prepladder.com/content/f1amSlsvXENFVabvsKQm1746700123.png", "https://image.prepladder.com/content/DOinHMms6OyYH0sgSAhV1746700148.png"], "explanation": "<p>Correct Option A - HLA B27</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p>Chronic <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> disease primarily affecting the <span class=\"customMeta\" data-dictid=\"01591f7f591692777182ef8aa2360c\">axial</span> <span class=\"customMeta\" data-dictid=\"70f596ae8f16927771983211d9e56f\">skeleton</span> (spine and <span class=\"customMeta\" data-dictid=\"1e5164b7d61692777198fcbb77e4ad\">sacroiliac</span> joints), leading to pain, stiffness, and <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> fusion<strong> (bamboo spine)</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Unknown; genetic<strong> (HLA-B27</strong>) and environmental factors involved. HLA-B27 is positive in 90% of cases, but not all carriers develop AS.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Inflammation at entheses → Erosive changes → New bone formation → Syndesmophytes → <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">Spinal</span> <span class=\"customMeta\" data-dictid=\"a7dfeb385e1692777203302bcf142d\">fusion</span> (ankylosis).</p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"635\" src=\"https://image.prepladder.com/content/7IH1iTlsFKo7Cql1Py0j1746700076.png\" width=\"635\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Musculoskeletal Symptoms:</strong></p>\n<ul>\n<li>Chronic low back pain (worse after inactivity, better with activity)</li>\n<li>Limited <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> mobility</li>\n<li>Enthesitis (Achilles, <span class=\"customMeta\" data-dictid=\"a7a430f3a9169277719510c13f434d\">plantar</span> fascia)</li>\n<li>Peripheral <span class=\"customMeta\" data-dictid=\"6f74c7bfe0169277718240005b59d1\">arthritis</span> (hips, shoulders, knees)</li>\n</ul>\n<p><strong>Extra-articular Symptoms:</strong></p>\n<ul>\n<li><strong>Ocular:</strong> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">Anterior</span> <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> (pain, redness, photophobia)</li>\n<li><strong>Cardiovascular:</strong> Aortic regurgitation, <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> issues</li>\n<li><strong>Pulmonary: </strong>Apical fibrosis</li>\n<li><strong>Gastrointestinal:</strong> Associated with IBD</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p>Based on clinical features, <span class=\"customMeta\" data-dictid=\"fe3220767716927771892419444041\">imaging</span> studies, and HLA-B27 gene presence. <strong>Modified New York Criteria:</strong></p>\n<p><strong>Clinical Criteria:</strong></p>\n<ul>\n<li>Low back pain &gt; 3 months (improves with exercise, not with rest)</li>\n<li>Limited <span class=\"customMeta\" data-dictid=\"683192f6b21692777191ae16feee76\">lumbar</span> spine motion (sagittal/frontal planes)</li>\n<li>Reduced chest expansion (relative to age/sex)</li>\n</ul>\n<p><strong>Radiographic Criteria (X-ray):</strong> Bilateral <span class=\"customMeta\" data-dictid=\"d17a3a17bc16927771988d9f2533a8\">sacroiliitis</span> (grade 2-4) or <span class=\"customMeta\" data-dictid=\"92b4dd0d9516927772013f2e4296b7\">unilateral</span> <span class=\"customMeta\" data-dictid=\"d17a3a17bc16927771988d9f2533a8\">sacroiliitis</span> (grade 3-4)</p>\n<p><strong>Radiological Features:</strong></p>\n<ul>\n<li>Blurring/haziness of <span class=\"customMeta\" data-dictid=\"1e5164b7d61692777198fcbb77e4ad\">sacroiliac</span> joint</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Hyun Kyu Chang, Eun Hee Cho, Jeong Uk Kim, Hwan Herr\" data-hash=\"\" data-license=\"CC BY NC 3.0\" data-source=\"https://www.researchgate.net/figure/Plain-pelvis-radiograph-shows-the-obliteration-of-joint-space-in-both-sacroiliac-joints_fig3_12601898\" data-tags=\"\" height=\"414\" src=\"https://image.prepladder.com/content/Cut7rBJVLym6tQnljMmR1746700088.png\" width=\"739\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Juxta-articular sclerosis</li>\n<li>Vertical/bridging syndesmophytes</li>\n<li>Squaring of vertebrae</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Glitzy_queen00\" data-hash=\"\" data-license=\"OPEN ACCESS\" data-source=\"https://commons.wikimedia.org/wiki/File:Ankylosing_spondylitis_lumbar_spine.jpg\" data-tags=\"\" height=\"916\" src=\"https://image.prepladder.com/content/ws50joqXNmytMvBmoCqJ1746700101.png\" width=\"455\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li>Bamboo spine</li>\n<li>Trolley track sign</li>\n<li>Dagger sign</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Gaillard F, Feger J, Niknejad M, et al.\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/dagger-sign-spine\" data-tags=\"\" height=\"604\" src=\"https://image.prepladder.com/content/bwdRrUJ2AUDMsnR3kPwq1746700113.png\" width=\"454\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<ul>\n<li><strong>Shiny corner sign/Romanus <span class=\"customMeta\" data-dictid=\"d5e7bb15851692777191b39417c26a\">lesion</span> </strong>(inflammatory lesions at edges of vertebrae)</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"https://radiopaedia.org/articles/shiny-corner-sign-ankylosing-spondylitis\" data-tags=\"\" height=\"995\" src=\"https://image.prepladder.com/content/f1amSlsvXENFVabvsKQm1746700123.png\" width=\"534\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n<p><strong>MRI:</strong> Early <span class=\"customMeta\" data-dictid=\"723fdec66b1692777186e92f0c6fdf\">detection</span> of inflammation</p>\n<p><strong>Clinical Tests:</strong></p>\n<p><strong>For Sacroiliitis:</strong></p>\n<ul>\n<li>Gaenslen’s test</li>\n<li>Patrick/FABER test</li>\n<li>Figure of 4 test</li>\n<li>Pump handle test</li>\n</ul>\n<p><strong>For <span class=\"customMeta\" data-dictid=\"683192f6b21692777191ae16feee76\">Lumbar</span> Spine:</strong></p>\n<p><strong>Schober/ Modified Schober test</strong></p>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"NA\" data-hash=\"\" data-license=\"NA\" data-source=\"NA\" data-tags=\"\" height=\"607\" src=\"https://image.prepladder.com/content/DOinHMms6OyYH0sgSAhV1746700148.png\" width=\"607\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Laboratory Tests</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>HLA-B27 positive (90% of cases)</li>\n<li>ESR, CRP: Elevated during active disease, but can be normal</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Differential Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Mechanical low back pain</li>\n<li>Other spondyloarthropathies (e.g., psoriatic arthritis)</li>\n<li>Degenerative disc disease</li>\n<li>Fibromyalgia</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Non-Pharmacological:</strong></p>\n<ul>\n<li>Physical therapy (mobility/posture exercises)</li>\n<li>Patient education on disease and exercise importance</li>\n</ul>\n<p><strong>Pharmacological:</strong></p>\n<ul>\n<li>NSAIDs (first-line for pain, stiffness)</li>\n<li>TNF inhibitors (for NSAID-resistant cases)</li>\n<li>IL-17 inhibitors (Secukinumab)</li>\n<li>Sulfasalazine (for <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> arthritis)</li>\n<li>Corticosteroids (short-term <span class=\"customMeta\" data-dictid=\"68e7440bd91692777202d8a14c33e0\">flare</span> control)</li>\n</ul>\n<p><strong>Surgical:</strong></p>\n<ul>\n<li>Hip replacement (for severe hip involvement)</li>\n<li>Spinal surgery (for severe deformities/fractures)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Spinal fractures (minimal trauma)</li>\n<li>Cardiac issues (aortic regurgitation, <span class=\"customMeta\" data-dictid=\"63bda90e3516927771848cbb473f04\">conduction</span> defects)</li>\n<li>Osteoporosis leading to <span class=\"customMeta\" data-dictid=\"e3727bc4841692777203d62242b6e6\">fracture</span> risk</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n<table align=\"left\" cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p><strong>Conditions mimicking Ankylosing Spondylitis with <span class=\"customMeta\" data-dictid=\"d816ba952f1692777199fc69bd7c56\">spinal</span> fusion</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Diffuse Idiopathic Skeletal Hyperostosis (DISH) (Forestier’s disease)</li>\n<li>Ossification of Posterior Longitudinal Ligament (OPLL)</li>\n<li>Spondylosis (Degenerative Disc Disease)</li>\n<li>Psoriatic Arthritis</li>\n<li>Enteropathic Arthritis (IBD-associated)</li>\n<li>Reactive Arthritis</li>\n<li>Rheumatoid Arthritis (RA)</li>\n<li>Juvenile Idiopathic Arthritis (JIA)</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "A 25-year-old male patient with a penetrating injury to the left eye was treated with corneoscleral suturing. Two months later, he returned with complaints of reduced near vision, pain, redness, and sensitivity to light in his right eye. Direct ophthalmoscopy revealed nodules in the fundus. Which part of the eye is affected?", "options": [{"label": "A", "text": "Uvea", "correct": true}, {"label": "B", "text": "Cornea", "correct": false}, {"label": "C", "text": "Conjunctiva", "correct": false}, {"label": "D", "text": "Sclera", "correct": false}], "correct_answer": "A. Uvea", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/KNYQosAoeuh8yjb9Cuvs1747042589.png"], "explanation": "<p>Correct Option A - Uvea</p>\n<table cellspacing=\"0\" style=\"border-collapse:collapse\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; vertical-align:top\">\n<p style=\"text-align:center\"><strong>Sympathetic <span class=\"customMeta\" data-dictid=\"722c35f97c169277719457b4886144\">ophthalmitis</span> (SO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Bilateral, granulomatous, <span class=\"customMeta\" data-dictid=\"4049e22a6b169277719429cb6c9514\">panuveitis</span> (Option A)</strong> occurring after <span class=\"customMeta\" data-dictid=\"55b31d659b16927771958a15837b10\">penetrating</span> trauma where <strong>uveal prolapse</strong> may have been a feature of the trauma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Etiology and pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Trauma to one eye <strong>(exciting eye) </strong>— 2 weeks to 3 months — <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">Uveitis</span> in the uninjured eye <strong>(sympathizing eye).</strong></li>\n<li><strong>T-cell mediated <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reaction to <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> S antigen. </strong></li>\n<li>Maximum risk upon injury to the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>Diffuse lymphocytic <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> of the choroid.</li>\n<li>Scattered aggregates of <span class=\"customMeta\" data-dictid=\"ed5f81953d1692777187529a6de318\">epithelioid</span> cells are seen, many of which contain fine granules of melanin.</li>\n<li><strong>Dalen–Fuchs nodules</strong> - granulomas located between Bruch <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> and the RPE (also seen in VKH syndrome)</li>\n</ul>\n<div style=\"text-align:center\">\n<figure class=\"caption_element\" style=\"display:inline-block\"><img alt=\"\" data-author=\"Xi K Chu,Chi-Chao Chan\" data-hash=\"\" data-license=\"CC BY 2.0\" data-source=\"https://www.researchgate.net/figure/Montage-fundus-photograph-of-a-sympathetic-ophthalmia-retina-Yellow-white-subretinal_fig1_237001131\" data-tags=\"\" height=\"443\" src=\"https://image.prepladder.com/content/KNYQosAoeuh8yjb9Cuvs1747042589.png\" width=\"507\"/>\n<figcaption>{{caption_text}}</figcaption>\n</figure>\n</div>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"da55d37dc51692777187ee41eeebc5\">exciting eye</span> is frequently red and irritable.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"659d09e49516927771995a19c72a5f\">sympathizing eye</span> develops irritation, blurred vision, <span class=\"customMeta\" data-dictid=\"46e2a1c298169277719583f46ff587\">photophobia</span> and loss of <span class=\"customMeta\" data-dictid=\"c0682eacfc1692777180ad2c556c19\">accommodation</span> causing difficulty in near vision <strong>(first symptom)</strong></li>\n<li>Anterior <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> develops in both eyes, which may be mild or severe and is usually granulomatous</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Fundus exam: </strong>Dalen–Fuchs nodules, Exudative <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, <span class=\"customMeta\" data-dictid=\"fcb3e0d7911692777201ffb9695dea\">vasculitis</span> and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc swelling.</li>\n<li>As <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> settles, <span class=\"customMeta\" data-dictid=\"a459f313d9169277719789fdfb7ada\">residual</span> <span class=\"customMeta\" data-dictid=\"3e48c7feaa169277718485430831dd\">chorioretinal</span> <span class=\"customMeta\" data-dictid=\"e9dcc3d4241692777198c7030bf313\">scarring</span> may confer a <strong>‘sunset glow’ appearance</strong> similar to VKH.</li>\n<li><strong>B-scan ultrasonography</strong>: Choroidal thickening and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top\">\n<ul>\n<li><strong>Enucleation of a severely injured eye</strong> within 10 to 14 days of the injury is effective in preventing or reducing the severity of SO</li>\n<li><strong>Steroids</strong> are the basis of initial treatment. <strong>Intravenous</strong> <span class=\"customMeta\" data-dictid=\"c3adf9f403169277719294351e8fb8\">methylprednisolone</span> followed by high-dose <strong>oral</strong> <span class=\"customMeta\" data-dictid=\"2d5e8899351692777196bdf7ced01d\">prednisolone</span> is given for several months and gradually tapered according to response. Supplementary <strong>topical</strong> steroids and cycloplegics may be given</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which medication can be administered to a patient diagnosed with acute anterior uveitis, presenting with symptoms of photophobia and blurred vision?", "options": [{"label": "A", "text": "Moxifloxacin", "correct": false}, {"label": "B", "text": "Atropine", "correct": true}, {"label": "C", "text": "Acetazolamide", "correct": false}, {"label": "D", "text": "Methotrexate", "correct": false}], "correct_answer": "B. Atropine", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option B - A\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "What is the specific sign that is pathognomonic for acute anterior uveitis among the options provided?", "options": [{"label": "A", "text": "Aqueous flare", "correct": false}, {"label": "B", "text": "Keratic precipitates", "correct": true}, {"label": "C", "text": "Festooned pupil", "correct": false}, {"label": "D", "text": "Bussaca’s nodules", "correct": false}], "correct_answer": "B. Keratic precipitates", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/VArPK7YmFWI3zxwoca6r1747043395.png", "https://image.prepladder.com/content/fu7uwRRvPjeVG4yAkr0s1747043408.png", "https://image.prepladder.com/content/IGcbx0qg8izTmzbda5ih1747043425.png"], "explanation": "<p>Correct Option B - K\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "On ophthalmologic examination, the presence of Koeppe's nodules is observed in a patient diagnosed with sarcoidosis. In which area of the eye are these nodules typically observed?", "options": [{"label": "A", "text": "Cornea", "correct": false}, {"label": "B", "text": "Conjunctiva", "correct": false}, {"label": "C", "text": "Iris", "correct": true}, {"label": "D", "text": "Retina", "correct": false}], "correct_answer": "C. Iris", "question_images": [], "explanation_images": ["https://image.prepladder.com/content/G4TceNfshIAlb4qAr1qR1714051194.png"], "explanation": "<p>Correct Option C: I\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which eye condition is commonly associated with sarcoidosis ?", "options": [{"label": "A", "text": "Cataract", "correct": false}, {"label": "B", "text": "Ectopia lentis", "correct": false}, {"label": "C", "text": "Anterior uveitis", "correct": true}, {"label": "D", "text": "Glaucoma", "correct": false}], "correct_answer": "C. Anterior uveitis", "question_images": [], "explanation_images": [], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following is not an ocular manifestation of dengue?", "options": [{"label": "A", "text": "Cataract", "correct": true}, {"label": "B", "text": "Subconjunctival hemorrhage", "correct": false}, {"label": "C", "text": "Uveitis", "correct": false}, {"label": "D", "text": "Retinal hemorrhage", "correct": false}], "correct_answer": "A. Cataract", "question_images": [], "explanation_images": [], "explanation": "<p>Correct Option A - Cataract: \n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 22 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A 42-year-old African American woman presents with visual disturbances. Eye examination reveals vitreous cells, snowball opacities, and candle wax drippings. Which type of uveitis is seen in the underlying disease?", "options": [{"label": "A", "text": "Anterior uveitis", "correct": false}, {"label": "B", "text": "Panuveitis", "correct": true}, {"label": "C", "text": "Posterior uveitis", "correct": false}, {"label": "D", "text": "Peripheral multifocal chorioretinitis", "correct": false}], "correct_answer": "B. Panuveitis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type of Uveitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior <strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Granulomatous iridocyclitis, <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">iris</span> nodules, large mutton fat KPs, <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber cells and flare, <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> synechiae</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Intermediate</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitreous cells, snowball opacities, snowbanking</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Posterior <strong>(Option C)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Choroidal and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> granulomas, <span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\">cystoid</span> <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, <span class=\"customMeta\" data-dictid=\"bd07bff8e716927771956e7a57bd70\">periphlebitis</span> retinae with <strong>candle <span class=\"customMeta\" data-dictid=\"9eae373ada1692777202074bbc0222\">wax</span> droppings appearance</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Peripheral <span class=\"customMeta\" data-dictid=\"225e0697ea1692777193892a2c34c7\">Multifocal</span> <span class=\"customMeta\" data-dictid=\"12a84ed9ce1692777184f7c9e6a65d\">Chorioretinitis</span> <strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Small, <span class=\"customMeta\" data-dictid=\"7134f7f8681692777196fa644c43bf\">punched-out</span> atrophic spots, highly suggestive of sarcoidosis</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Uveoparotid Fever (Heerfordt’s Syndrome)</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Bilateral <span class=\"customMeta\" data-dictid=\"9e1f97f6ad169277718805c2dd35c1\">granulomatous</span> panuveitis, painful <span class=\"customMeta\" data-dictid=\"42d0553c3916927771944110a6f15b\">parotid</span> <span class=\"customMeta\" data-dictid=\"4744bb90c21692777188c8957f9faa\">gland</span> enlargement, <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve palsies, skin rashes, fever, malaise</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/I43l1OM5mIWDcqt8BfA71746453898.mp3", "video": ""}, {"text": "Which of the following conditions can cause panuveitis?", "options": [{"label": "A", "text": "VKH syndrome", "correct": false}, {"label": "B", "text": "Sympathetic Ophthalmia", "correct": false}, {"label": "C", "text": "Sarcoidosis", "correct": false}, {"label": "D", "text": "All of the above", "correct": true}], "correct_answer": "D. All of the above", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:NaN\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Autoimmune</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infectious</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Sarcoidosis.</li>\n<li>Birdshot retinochoroidopathy.</li>\n<li>Sympathetic ophthalia.</li>\n<li>Polyarteritis nodosa.</li>\n<li>Lens-induced.</li>\n</ul>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Infections (syphilis, TB, HSV/VZV, toxoplasmosis, cryptococcosis).</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/F7dVPMZy39C5NfZRRzU11746629889.mp3", "video": ""}, {"text": "A 45-year-old male presents with vision loss in his right eye following a traumatic injury that resulted in a penetrating ocular wound two months ago. Recently, he has developed redness, photophobia, and decreased vision in his left eye as well. On examination, both eyes show signs of bilateral granulomatous uveitis. Which of the following best explains the pathogenesis of the patient's condition?", "options": [{"label": "A", "text": "Type I hypersensitivity reaction to lens proteins", "correct": false}, {"label": "B", "text": "Delayed hypersensitivity reaction to melanocytes", "correct": true}, {"label": "C", "text": "Direct bacterial infection spreading from the injured eye", "correct": false}, {"label": "D", "text": "Immune complex deposition in the retinal vasculature", "correct": false}], "correct_answer": "B. Delayed hypersensitivity reaction to melanocytes", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Sympathetic <span class=\"customMeta\" data-dictid=\"722c35f97c169277719457b4886144\">ophthalmitis</span> (SO)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bilateral, granulomatous, panuveitis</strong> occurring after <span class=\"customMeta\" data-dictid=\"55b31d659b16927771958a15837b10\">penetrating</span> trauma where <strong>uveal prolapse</strong> may have been a feature of the trauma</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Etiology and pathogenesis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Trauma to one eye <strong>(exciting eye) </strong>— 2 weeks to 3 months — <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">Uveitis</span> in the uninjured eye <strong>(sympathizing eye).</strong></li>\n<li><strong>T-cell mediated <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> <span class=\"customMeta\" data-dictid=\"2c7e1ce33316927771892ce1da8276\">hypersensitivity</span> reaction to <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">Retinal</span> S antigen. </strong><strong>(Option B)</strong></li>\n<li>Maximum risk upon injury to the <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Histopathology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Diffuse lymphocytic <span class=\"customMeta\" data-dictid=\"669bdcb3111692777190e018ae930e\">infiltration</span> of the choroid.</li>\n<li>Scattered aggregates of <span class=\"customMeta\" data-dictid=\"ed5f81953d1692777187529a6de318\">epithelioid</span> cells are seen, many of which contain fine granules of melanin.</li>\n<li>Dalen–Fuchs nodules - granulomas located between Bruch <span class=\"customMeta\" data-dictid=\"34cd707428169277719272942b7905\">membrane</span> and the <span class=\"customMeta\" data-dictid=\"142f8e4f971692777197f051738400\">RPE</span> (also seen in VKH syndrome)</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>The <span class=\"customMeta\" data-dictid=\"da55d37dc51692777187ee41eeebc5\">exciting eye</span> is frequently red and irritable.</li>\n<li>The <span class=\"customMeta\" data-dictid=\"659d09e49516927771995a19c72a5f\">sympathizing eye</span> develops irritation, blurred vision, <span class=\"customMeta\" data-dictid=\"46e2a1c298169277719583f46ff587\">photophobia</span> and loss of <span class=\"customMeta\" data-dictid=\"c0682eacfc1692777180ad2c556c19\">accommodation</span> causing difficulty in near vision <strong>(first symptom)</strong></li>\n<li>Anterior <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> develops in both eyes, which may be mild or severe and is usually granulomatous</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Fundus exam: </strong>Dalen–Fuchs nodules, <span class=\"customMeta\" data-dictid=\"8388ec88871692777187acdf19cc80\">Exudative</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, <span class=\"customMeta\" data-dictid=\"fcb3e0d7911692777201ffb9695dea\">vasculitis</span> and <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc swelling.</li>\n<li>As <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> settles, <span class=\"customMeta\" data-dictid=\"a459f313d9169277719789fdfb7ada\">residual</span> <span class=\"customMeta\" data-dictid=\"3e48c7feaa169277718485430831dd\">chorioretinal</span> <span class=\"customMeta\" data-dictid=\"e9dcc3d4241692777198c7030bf313\">scarring</span> may confer a <strong>‘sunset glow’ appearance</strong> similar to VKH.</li>\n<li><strong>B-scan ultrasonography</strong>: <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">Choroidal</span> thickening and <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Enucleation of a severely injured eye</strong> within 10 to 14 days of the injury is effective in preventing or reducing the severity of SO</li>\n<li><strong>Steroids</strong> are the basis of initial treatment. <strong>Intravenous</strong> <span class=\"customMeta\" data-dictid=\"c3adf9f403169277719294351e8fb8\">methylprednisolone</span> followed by high-dose <strong>oral</strong> <span class=\"customMeta\" data-dictid=\"2d5e8899351692777196bdf7ced01d\">prednisolone</span> is given for several months and gradually tapered according to response. Supplementary <strong>topical</strong> steroids and cycloplegics may be given</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/XOc29fqJYu4LTnukmUPL1746630193.mp3", "video": ""}, {"text": "A 28-year-old woman diagnosed with Vogt–Koyanagi–Harada (VKH) disease, Fundus examination shows the following findings. What does it indicate?", "options": [{"label": "A", "text": "Prodromal phase", "correct": false}, {"label": "B", "text": "Uveitic phase", "correct": false}, {"label": "C", "text": "Convalescent phase", "correct": true}, {"label": "D", "text": "Recurrent phase", "correct": false}], "correct_answer": "C. Convalescent phase", "question_images": ["https://image.prepladder.com/notes/VUVeEm0pC3ip6SDFrYjI1743754453.png"], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Vogt–Koyanagi–Harada (VKH) Syndrome</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Definition</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Idiopathic <strong>multisystem <span class=\"customMeta\" data-dictid=\"96ab11a06a16927771823151c8e471\">autoimmune</span> disease </strong>featuring <strong>inflammation of melanocyte-containing tissues</strong> such as the <strong>uvea, ear, and meninges.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Etiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Idiopathic.</li>\n<li><strong>HLA associations: </strong>HLA-DR1 and HLA-DR4.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Classification</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Vogt–Koyanagi disease:</strong> Skin changes and <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis.</li>\n<li><strong>Harada disease:</strong> Neurological features and <span class=\"customMeta\" data-dictid=\"8388ec88871692777187acdf19cc80\">exudative</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachments.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Clinical features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Clinically, the disease is categorized into<strong> four </strong>phases:</p>\n<ol>\n<li><strong>Prodromal phase</strong> (lasts for a few days): Neurological (meningitis, <span class=\"customMeta\" data-dictid=\"6b7b5460171692777185e6e2475f8c\">cranial</span> nerve paresis) and <span class=\"customMeta\" data-dictid=\"f17057f75016927771829e70074368\">auditory</span> manifestations (tinnitus, <span class=\"customMeta\" data-dictid=\"7d489fad971692777201210257b018\">vertigo</span> and deafness).</li>\n<li><strong>Acute uveitic phase: </strong>Bilateral <span class=\"customMeta\" data-dictid=\"9e1f97f6ad169277718805c2dd35c1\">granulomatous</span> <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> and <span class=\"customMeta\" data-dictid=\"225e0697ea1692777193892a2c34c7\">multifocal</span> <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> with <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">diffuse</span> <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> infiltration, vitritis, <span class=\"customMeta\" data-dictid=\"292df950dc169277719497d55b3cfe\">papillitis</span> and <span class=\"customMeta\" data-dictid=\"8388ec88871692777187acdf19cc80\">exudative</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachments. Dalen–Fuchs nodules can be seen in this phase.</li>\n<li><strong>Convalescent phase </strong>(follows several weeks later)<strong>: </strong>Localized alopecia, <span class=\"customMeta\" data-dictid=\"d235fe983316927771968b9f8a9dca\">poliosis</span> and vitiligo, depigmented <span class=\"customMeta\" data-dictid=\"67492c42be16927772039f6e37110e\">fundus</span> appearance (‘sunset glow’ fundus) and depigmented <span class=\"customMeta\" data-dictid=\"71928251b41692777191a31e57c47f\">limbal</span> lesions (Sugiura sign). <strong>(Option C)</strong></li>\n<li><strong>Chronic <span class=\"customMeta\" data-dictid=\"c64e3a661b1692777197afc2ff7bca\">recurrent</span> phase: </strong>smouldering <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> with exacerbations</li>\n</ol>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Investigations</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Lumbar puncture: </strong>CSF shows a <span class=\"customMeta\" data-dictid=\"a6cf2c3dc51692777200ef7fb22f69\">transient</span> lymphocytic <span class=\"customMeta\" data-dictid=\"83e27900ef1692777195384e008950\">pleocytosis</span> and melanin-containing macrophages.</li>\n<li><strong>Fundus Autofluorescence</strong> (FAF): Areas of <span class=\"customMeta\" data-dictid=\"3963a2e0fa169277719874304f5705\">serous</span> detachment.</li>\n<li><strong>Ultrasonography</strong>: <span class=\"customMeta\" data-dictid=\"89275101301692777186567d1912a0\">Diffuse</span> <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> thickening.</li>\n<li><strong>FA </strong>(Fluorescein Angiography) of the <span class=\"customMeta\" data-dictid=\"4cdc8161f71692777180df58cafa93\">acute</span> phase shows <span class=\"customMeta\" data-dictid=\"225e0697ea1692777193892a2c34c7\">multifocal</span> hyperfluorescent dots at the level of the <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> epithelium.</li>\n<li><strong>OCT</strong>: Quantification of <span class=\"customMeta\" data-dictid=\"7c6ceacf801692777199b31cdb3fc6\">subretinal</span> fluid.</li>\n<li><strong>ICGA</strong>: For monitoring</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Complications and Prognosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Ocular complications include:</p>\n<ul>\n<li>Choroidal neovascularization</li>\n<li>Subretinal fibrosis</li>\n<li>Preretinal and disc new vessels</li>\n<li>Vitreous hemorrhage</li>\n<li>Cataract</li>\n<li>Glaucoma</li>\n</ul>\n<p>Neurological and <span class=\"customMeta\" data-dictid=\"f17057f75016927771829e70074368\">auditory</span> manifestations tend to resolve but <strong>skin, lash and hair changes usually persist.</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p style=\"text-align: center;\"><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li><strong>Intravenous methylprednisolone</strong> pulse therapy (500–1000 mg/day).</li>\n<li>High-dose (1–2 mg/kg/day) <strong>oral prednisolone</strong>, tapered over 3–6 months.</li>\n<li><strong>Topical steroids </strong>and <strong>cycloplegics</strong> are used for <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> uveitis.</li>\n<li>Steroid-resistant patients may require <strong>immunosuppressives</strong> or biological blockers such as <strong>infliximab</strong></li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/dPE8NKPwS4Pq2E2zAL4C1746630806.mp3", "video": ""}, {"text": "A 35-year-old male presents with progressively worsening blurry vision, eye pain, and redness in the right eye. Examination reveals restricted eye movement, and fundoscopic evaluation identifies a well-defined cystic lesion in the vitreous humor, accompanied by surrounding inflammation. What is the most probable diagnosis in this patient?", "options": [{"label": "A", "text": "Ocular toxoplasmosis", "correct": false}, {"label": "B", "text": "Endophthalmitis", "correct": false}, {"label": "C", "text": "Ocular cysticercosis", "correct": true}, {"label": "D", "text": "Posterior uveitis due to tuberculosis", "correct": false}], "correct_answer": "C. Ocular cysticercosis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:624px\">\n<tbody>\n<tr>\n<td colspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ocular cysticercosis</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Definition </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Infestation caused by <strong>Cysticercus cellulosae</strong>, the <span class=\"customMeta\" data-dictid=\"7a9967010c16927771914174ab4e92\">larval</span> <span class=\"customMeta\" data-dictid=\"a1b06f401f1692777203a53393ba98\">form</span> of the <strong>pork tapeworm</strong> <strong>Taenia solium</strong>.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pathophysiology</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Humans ingest eggs of T. solium, leading to <strong>larvae formation (cysticercus) in various tissues. </strong></p>\n<p>Inflammation is <span class=\"customMeta\" data-dictid=\"3978e9614f1692777200abbe4cfa34\">triggered</span> by <strong>antigens released from dead larvae</strong>, leading to tissue damage.</p>\n<p>It is <strong>not contracted by eating undercooked pork.</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Systemic Involvement: </strong>Larvae can infest the <span class=\"customMeta\" data-dictid=\"e1a4a12fb416927771841c46faf6fb\">CNS</span> (neurocysticercosis), muscles, lungs, and <span class=\"customMeta\" data-dictid=\"d446e62c6c1692777199896fc1d4b9\">subcutaneous</span> tissues. Neurological manifestations include seizures and headaches.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Eye involvement:</strong></p>\n<ul>\n<li><strong>Orbit and adnexal cysticercosis: </strong>\n<ul>\n<li>The <strong>extraocular muscles (superior rectus- most common) </strong>form is the most common type of <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> and adnexal cysticercosis.</li>\n<li>Presents as <span class=\"customMeta\" data-dictid=\"e25c12b0d21692777195e9dbff2422\">periocular</span> swelling, proptosis, ptosis, pain, diplopia, restriction of <span class=\"customMeta\" data-dictid=\"7b1f175723169277719459db16938e\">ocular</span> motility, strabismus, decreased vision, lid <span class=\"customMeta\" data-dictid=\"18b452e75916927771864c9ad533e1\">edema</span> and <span class=\"customMeta\" data-dictid=\"bfe6beb7131692777194500ac5f2d2\">orbital</span> cellulitis.</li>\n</ul>\n</li>\n<li><strong>Ocular cysticercosis:</strong>\n<ul>\n<li>Intraocular <span class=\"customMeta\" data-dictid=\"183a3f89521692777185a6d0144d6c\">cysticercosis</span> can involve either the <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> or the <strong>posterior segment (more common).</strong></li>\n<li>Presents as blurring of vision, uveitis, vitritis, scotoma, and photopsia.</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Diagnosis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>B-scan Ultrasound: </strong>Diagnostic for <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> cysticercosis; <span class=\"customMeta\" data-dictid=\"5df6bd6fd716927771980b637094fa\">scolex</span> within the <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> can be identified.</p>\n<p><strong>Serology: </strong>Detection of anti-cysticercus antibodies via ELISA.</p>\n<p><strong>Ophthalmic Examination: </strong>Identification of cysts in the AC or vitreous, signs of <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> or <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Ocular cysticercosis:</strong></p>\n<p><strong>Surgical Treatment: </strong>Early removal of cysts via <span class=\"customMeta\" data-dictid=\"4bc4237fe3169277719497604c0f00\">pars</span> <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">plana</span> <span class=\"customMeta\" data-dictid=\"e6aa17c07816927772024116d41015\">vitrectomy</span> (PPV) or transscleral approach depending on <span class=\"customMeta\" data-dictid=\"1405ad7b46169277718580acad7562\">cyst</span> location.</p>\n<p><strong>Steroids: </strong>Systemic corticosteroids are used to control <span class=\"customMeta\" data-dictid=\"e747a47db616927771908bff4b8931\">inflammation</span> post-surgery.</p>\n<p><strong>Medical Management: </strong>Albendazole and corticosteroids are used for <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">systemic</span> <span class=\"customMeta\" data-dictid=\"97f6c38301169277719097d4d23cff\">infestation</span> but with caution in <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> cases to avoid severe <span class=\"customMeta\" data-dictid=\"9d21dd5d3116927771907405b181bc\">inflammatory</span> reactions caused by dying cysts.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/xOi9TvHX8Oj2PjeEjc9Z1746632850.mp3", "video": ""}, {"text": "Which of the following ocular conditions is most commonly associated with a positive Amsler sign?", "options": [{"label": "A", "text": "Cataract", "correct": false}, {"label": "B", "text": "Ocular histoplasmosis syndrome", "correct": false}, {"label": "C", "text": "Fuchs heterochromatic uveitis", "correct": true}, {"label": "D", "text": "Acute retinal necrosis", "correct": false}], "correct_answer": "C. Fuchs heterochromatic uveitis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/qPqa3H9hRe8KO9VnT6T41743127102.png", "https://image.prepladder.com/notes/qds01CqZ7km8jvJupmLi1743127162.png", "https://image.prepladder.com/notes/IemIk0n0MHSPhFHnvJwl1743127228.png"], "explanation": "\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2pp1IwH0tBqm6IrAPSIS1746633364.mp3", "video": ""}, {"text": "A 35-year-old male with a recent travel history to Africa presents with intense itching, skin nodules, and progressive vision loss. On examination, multiple palpable nodules are found on his skin, and there is early corneal clouding. Microfilariae are observed in a skin snip biopsy. What is the most appropriate treatment for this condition?", "options": [{"label": "A", "text": "Clindamycin + sulfadiazine", "correct": false}, {"label": "B", "text": "Diethylcarbamazine", "correct": false}, {"label": "C", "text": "Ivermectin", "correct": true}, {"label": "D", "text": "Self-limiting condition, no treatment needed", "correct": false}], "correct_answer": "C. Ivermectin", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/q3TujPtju59KTWDDReMr1743126813.png", "https://image.prepladder.com/notes/Hg8H8mWG7kQ01Dgm5vlN1743126881.png", "https://image.prepladder.com/notes/8AREFh3xu36JxvSFAc401743126944.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/T032gdwGhlafCt83DneX1746671341.mp3", "video": ""}, {"text": "A 32-year-old immunocompromised woman living with cats presents with decreased vision in her left eye. On examination, she has mild anterior uveitis with vitritis and the fundoscopy image is shown below. Which of the following is the most likely causative organism?", "options": [{"label": "A", "text": "Cytomegalovirus (CMV)", "correct": false}, {"label": "B", "text": "Candida albicans", "correct": false}, {"label": "C", "text": "Toxoplasma gondii", "correct": true}, {"label": "D", "text": "Histoplasma capsulatum", "correct": false}], "correct_answer": "C. Toxoplasma gondii", "question_images": ["https://image.prepladder.com/notes/oCrSAF3OLrcdJVtP8nXk1746709390.png"], "explanation_images": ["https://image.prepladder.com/notes/CtWVL4nk6yK4h3JssqzU1743126482.png", "https://image.prepladder.com/notes/oCrSAF3OLrcdJVtP8nXk1746709390.png", "https://image.prepladder.com/notes/9U61ccYzc08qwJs26U981743126615.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/gv2kC3waISFThnITzgDp1746629725.mp3", "video": ""}, {"text": "Match bacterial uveitis in column A with corresponding clinical manifestation in column B Bacterial uveitis Clinical features 1. Tubercular uveitis a. Iris pearls 2. Leprotic uveitis b. Iris roceola 3. Spirochetal uveitis c. Headlight in fog appearance d. Koeppe’s nodules", "options": [{"label": "A", "text": "1-d, 2-a, 3-b", "correct": true}, {"label": "B", "text": "1-b, 2-c, 3-d", "correct": false}, {"label": "C", "text": "1-c, 2-d, 3-a", "correct": false}, {"label": "D", "text": "1-b, 2-a, 3-d", "correct": false}], "correct_answer": "A. 1-d, 2-a, 3-b", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/OnGGTdkiiWPNoRp9plqz1743124885.png", "https://image.prepladder.com/notes/K1CSYJL8GzrLobT0G7dO1743126127.png", "https://image.prepladder.com/notes/BN5sGEopVuOkLNeAb1cX1743126208.png", "https://image.prepladder.com/notes/eW0BxblzjfFhG3qWSXK71743126284.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:590px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacterial uveitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Clinical features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1. <span class=\"customMeta\" data-dictid=\"daf5ee63361692777201129f498a4d\">Tubercular</span> uveitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>d. Koeppe’s nodules</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2. Leprotic uveitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>a. <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">Iris</span> pearls</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3. <span class=\"customMeta\" data-dictid=\"e071d0bb191692777199a62b511d8f\">Spirochetal</span> uveitis</p>\n</td>\n<td rowspan=\"2\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>b. <span class=\"customMeta\" data-dictid=\"6e53fc929616927771900fbab3617f\">Iris</span> roceola</p>\n</td>\n</tr>\n<tr>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/2MGJb3t83jeT67kyAs4K1745224901.mp3", "video": ""}, {"text": "A 34-year-old woman with a history of Crohn’s disease presents with sudden onset of eye pain, redness, and blurred vision. Slit-lamp examination reveals fine, grey keratic precipitates, anterior chamber cells, and flare. Which type of uveitis is most consistent with her presentation?", "options": [{"label": "A", "text": "Granulomatous uveitis", "correct": false}, {"label": "B", "text": "Non-granulomatous anterior uveitis", "correct": true}, {"label": "C", "text": "Posterior uveitis", "correct": false}, {"label": "D", "text": "Both A and C are correct", "correct": false}], "correct_answer": "B. Non-granulomatous anterior uveitis", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/HbygUuxoO2i0hVUavqSX1746629203.mp3", "video": ""}, {"text": "A 30-year-old patient with HIV presents with vision loss and floaters. On examination, the patient has a CD4+ count of 40 cells/mm³. Fundoscopy reveals areas of necrosis with the following appearance. What is the most likely diagnosis?", "options": [{"label": "A", "text": "Toxoplasmosis", "correct": false}, {"label": "B", "text": "Herpes Simplex Virus (HSV) Retinitis", "correct": false}, {"label": "C", "text": "CMV retinitis", "correct": true}, {"label": "D", "text": "Herpes Zoster Ophthalmicus", "correct": false}], "correct_answer": "C. CMV retinitis", "question_images": ["https://image.prepladder.com/notes/OT8RgBb2syVNXgyQzMeh1743125826.png"], "explanation_images": ["https://image.prepladder.com/notes/OT8RgBb2syVNXgyQzMeh1743125826.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}, {"text": "Which of the following statements about the uveal tract is false?", "options": [{"label": "A", "text": "The choroid connects anteriorly to the iris via the ciliary body.", "correct": false}, {"label": "B", "text": "The ciliary body contains both radial and circular smooth muscle fibers.", "correct": false}, {"label": "C", "text": "The posterior layer of the iris is continuous with the ciliary body", "correct": false}, {"label": "D", "text": "The constrictor pupillae muscle is controlled by sympathetic nerves.", "correct": true}], "correct_answer": "D. The constrictor pupillae muscle is controlled by sympathetic nerves.", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/mbWChvHWvLhYRRtWjZKE1743124604.png", "https://image.prepladder.com/notes/QMwplgoAn3xkWQUF99Hz1743124658.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/kw6Jx6bpqELY0L9WuB3L1746453105.mp3", "video": ""}, {"text": "A 30-year-old man presents with symptoms of recurrent bilateral eye inflammation, including redness, pain, and vision loss. He also has a history of frequent oral and genital ulcers and skin rashes. He is HLA-B51 positive. What would be the most appropriate approach for managing his uveitis?", "options": [{"label": "A", "text": "Start with systemic corticosteroids and consider long-term immunosuppressive therapy", "correct": true}, {"label": "B", "text": "Immediate initiation of antiviral therapy", "correct": false}, {"label": "C", "text": "Use of topical antibiotics for ocular symptoms", "correct": false}, {"label": "D", "text": "Prescription of oral antihistamines for symptom relief", "correct": false}], "correct_answer": "A. Start with systemic corticosteroids and consider long-term immunosuppressive therapy", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/MlRk1J4RPlZE9G7Ve7Fk1746628635.mp3", "video": ""}, {"text": "A 30-year-old man with a recent history of urethritis and arthritis presents with eye symptoms. He is positive for HLA-B27. What is the most appropriate initial treatment?", "options": [{"label": "A", "text": "Oral antibiotics", "correct": false}, {"label": "B", "text": "Topical corticosteroids", "correct": true}, {"label": "C", "text": "Systemic tetracycline", "correct": false}, {"label": "D", "text": "Immunosuppressive agents", "correct": false}], "correct_answer": "B. Topical corticosteroids", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ixci2owrESUOoeDMCrwr1746628356.mp3", "video": ""}, {"text": "A 45-year-old male presents with unilateral eye pain, photophobia, and redness for the past five days. Slit-lamp examination reveals circumcorneal injection, anterior chamber cells and flare, and posterior synechiae. Despite initial treatment with topical corticosteroids and cycloplegics, his symptoms persist, and intraocular pressure (IOP) is found to be elevated. Which of the following is the most likely complication of the condition he is suffering from?", "options": [{"label": "A", "text": "Retinal detachment", "correct": false}, {"label": "B", "text": "Secondary glaucoma", "correct": true}, {"label": "C", "text": "Vitreous hemorrhage", "correct": false}, {"label": "D", "text": "Optic neuritis", "correct": false}], "correct_answer": "B. Secondary glaucoma", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:625px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complication</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Description</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Additional Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Complicated Cataract</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common in iridocyclitis, characterized by <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> <span class=\"customMeta\" data-dictid=\"550fa75ff216927771992c0987c58e\">subcapsular</span> opacities with \"<strong>polychromatic luster</strong>\" and \"<strong>bread-crumb</strong>\" appearance.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Matures faster with <span class=\"customMeta\" data-dictid=\"a5c6cb079d16927771967e62ffee72\">posterior</span> synechiae presence.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Secondary Glaucoma</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Can occur early or late due to iridocyclitis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Early: Usually Open-angle. <span class=\"customMeta\" data-dictid=\"43c30dc8c8169277718317ffb7dea0\">Blockage</span> of trabecular <span class=\"customMeta\" data-dictid=\"21a7bbd1e416927771923570b66aad\">meshwork</span> by exudates/inflammatory cells.</li>\n<li>Late: Usually Closed. Pupillary block causes impaired <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> humor flow.</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cyclitic Membrane</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Late <span class=\"customMeta\" data-dictid=\"8a6b09beac1692777184b08a2b5766\">complication</span> where exudates behind the lens become organized in <strong>acute plastic iridocyclitis</strong>.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Choroiditis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Long-standing <span class=\"customMeta\" data-dictid=\"5d80cc9ebc16927771907b9a2d7dc5\">iridocyclitis</span> can lead to <span class=\"customMeta\" data-dictid=\"91606261e316927771844d1049c97b\">choroiditis</span> due to the <span class=\"customMeta\" data-dictid=\"17e718612e1692777185f79acb759b\">continuity</span> of the iris, <span class=\"customMeta\" data-dictid=\"1be9f55b2d1692777184b9d813b17e\">ciliary</span> body, and choroid.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Retinal Complications</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Includes <span class=\"customMeta\" data-dictid=\"99516d71df1692777185eb2585a44f\">cystoid</span> <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> edema, <span class=\"customMeta\" data-dictid=\"ebad8eb48c1692777191b5de5d04a1\">macular</span> scar/hole, <span class=\"customMeta\" data-dictid=\"6aadb11fcb169277718789588782cc\">epiretinal</span> membrane, <span class=\"customMeta\" data-dictid=\"8388ec88871692777187acdf19cc80\">exudative</span> <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, secondary <span class=\"customMeta\" data-dictid=\"bd07bff8e716927771956e7a57bd70\">periphlebitis</span> retinae, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> scars, sub-retinal fibrosis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Papillitis</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Inflammation of the <span class=\"customMeta\" data-dictid=\"1b9a354cdb1692777194802683234d\">optic</span> disc, seen in severe cases of iridocyclitis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Band-shaped Keratopathy</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Common in children with Still’s disease and chronic uveitis.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Phthisis Bulbi</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Final stage of chronic <span class=\"customMeta\" data-dictid=\"b07d6fd6ef1692777201015472cd79\">uveitis</span> where the eye becomes soft, shrunken, and atrophic.</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<ul>\n<li>Without Shrinkage: Globe shape intact, vision loss, <span class=\"customMeta\" data-dictid=\"4f08463b141692777183c171d13f9a\">cataractous</span> lens, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment, raised <span class=\"customMeta\" data-dictid=\"44317409bb16927771907e9af17a8b\">IOP</span> early.</li>\n<li>With Shrinkage: Lowered IOP, collapsed <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> chamber, shrunken eyeball.</li>\n<li>With Disorganization: Significant <span class=\"customMeta\" data-dictid=\"53c6bebcbb169277718777b3fe0e5c\">eyeball</span> reduction, scleral thickening, possible <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">intraocular</span> ossification.</li>\n</ul>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/YroNdh0rCg6uMUMAyaBZ1746628114.mp3", "video": ""}, {"text": "Which of the following is not a component of Posterior uveitis?", "options": [{"label": "A", "text": "Retinitis", "correct": false}, {"label": "B", "text": "Choroiditis", "correct": false}, {"label": "C", "text": "Iridocyclitis", "correct": true}, {"label": "D", "text": "Retinal vasculitis", "correct": false}], "correct_answer": "C. Iridocyclitis", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Category</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Examples</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"4\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Infectious Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Viruses</strong>: CMV, HSV, <span class=\"customMeta\" data-dictid=\"e502fd2a6816927771880ae17fc163\">herpes</span> zoster, rubella, measles</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Bacteria</strong>: <em>Mycobacterium tuberculosis</em>, <em>Brucella</em> spp., <em>Borrelia burgdorferi</em>, other <span class=\"customMeta\" data-dictid=\"c72cd5f69316927771883c73649d86\">gram-positive</span> and <span class=\"customMeta\" data-dictid=\"08cb2b02c81692777188b83845c84c\">gram-negative</span> bacteria</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Fungi</strong>: <em>Candida</em> spp., <em>Histoplasma capsulatum</em>, <em>Blastomyces</em> spp., <em>Cryptococcus neoformans</em>, <em>Aspergillus</em> spp.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Parasites</strong>: <em>Toxoplasma gondii</em>, <em>Toxocara</em> spp., <em>Onchocerca volvulus</em>, <em>Acanthamoeba</em> spp.</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Non-Infectious Causes</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Autoimmune</strong>: Behçet's disease, VKH syndrome, SLE, Wegener's granulomatosis, <span class=\"customMeta\" data-dictid=\"5731c5431416927771999e54e2563b\">sympathetic</span> ophthalmia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Malignancy</strong>: <span class=\"customMeta\" data-dictid=\"1ba26fe8171692777190a867ec47c7\">Intraocular</span> lymphoma, <span class=\"customMeta\" data-dictid=\"f8aaf091221692777191f73e810e94\">malignant</span> melanoma, leukemia</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Unknown Etiology</strong>: Sarcoidosis, <span class=\"customMeta\" data-dictid=\"7ab35d64bd16927771981c8135b442\">serpiginous</span> choroiditis, Birdshot chorioretinopathy, <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"85dafbf32f1692777195b9d9f035d8\">pigmented</span> epitheliopathy</p>\n</td>\n</tr>\n</tbody>\n</table>\n<table cellspacing=\"0\" style=\"border-collapse:collapse; width:614px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Type</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Features</strong></p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"5\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Symptoms</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Defective Vision</strong>: Ranges from mild blurriness to severe vision loss</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Photopsia</strong>: Flashes of light from <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> irritation</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Floaters</strong>: Black spots or cobwebs due to <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> debris</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Metamorphopsia</strong>: Distorted vision, with straight lines appearing wavy</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Scotoma</strong>: <span class=\"customMeta\" data-dictid=\"20fdb467921692777183b457fca572\">Blind spot</span> or <span class=\"customMeta\" data-dictid=\"10c83adb331692777197f775bec1aa\">reduced</span> vision area in the visual field</p>\n</td>\n</tr>\n<tr>\n<td rowspan=\"3\" style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Signs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Vitreous Opacities</strong>: Fine or <span class=\"customMeta\" data-dictid=\"28606fa66a169277718407469e7e7c\">coarse</span> opacities, \"snowballs\", or strands in the <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> humor</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Active <span class=\"customMeta\" data-dictid=\"3e48c7feaa169277718485430831dd\">Chorioretinal</span> Lesions</strong>: Pale yellow or white, raised areas with blurred margins; possible <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> haziness and vasculitis </p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Healed <span class=\"customMeta\" data-dictid=\"3e48c7feaa169277718485430831dd\">Chorioretinal</span> Lesions</strong>: White, atrophic areas with <span class=\"customMeta\" data-dictid=\"cea77d01ce1692777184854450c378\">choroidal</span> thinning; black <span class=\"customMeta\" data-dictid=\"05e2e2617c16927771952bcbeea08b\">pigment</span> <span class=\"customMeta\" data-dictid=\"7cc5d500951692777184bdd73ef72d\">clumping</span> at edges </p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/fzPSfvKmEl7Zyll5pz4c1746520690.mp3", "video": ""}, {"text": "What is the 1st line of treatment in a 35 year old patient presenting with Intermediate uveitis?", "options": [{"label": "A", "text": "Pars plana vitrectomy", "correct": false}, {"label": "B", "text": "Systemic steroids", "correct": false}, {"label": "C", "text": "Periocular injection of triamcinolone", "correct": true}, {"label": "D", "text": "Cryotherapy", "correct": false}], "correct_answer": "C. Periocular injection of triamcinolone", "question_images": [], "explanation_images": [], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:707px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Step</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Treatment</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Details</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>1</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Periocular &amp; <span class=\"customMeta\" data-dictid=\"8f2e7fd96116927771995b451b5c90\">Systemic</span> Steroids </strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Triamcinolone injection</strong>: 40 mg, 3 injections spaced 3 weeks apart.</p>\n<p><strong>Oral corticosteroids:</strong> Typically considered if <span class=\"customMeta\" data-dictid=\"e25c12b0d21692777195e9dbff2422\">periocular</span> steroids are insufficient. Gradual tapering is done. <strong>(Option B)</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>2</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Immunosuppressive Drugs</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Agents</strong>: Cyclosporine, azathioprine, methotrexate, cyclophosphamide.</p>\n<p>Close monitoring due to potential side effects.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>3</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cryotherapy/Indirect Laser <span class=\"customMeta\" data-dictid=\"10cb4498ea1692777195b60ee356a3\">Photocoagulation</span> </strong><strong>(Option D)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Cryotherapy</strong>: Controlled cold-induced injury. Used for snowbanking when less <span class=\"customMeta\" data-dictid=\"1c5272ad3d1692777190e71409d07a\">invasive</span> treatments fail.</p>\n<p>Laser photocoagulation: Focused light beam treatment.</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>4</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Pars <span class=\"customMeta\" data-dictid=\"2d0756b0d11692777195ef3bcd110d\">Plana</span> <span class=\"customMeta\" data-dictid=\"e6aa17c07816927772024116d41015\">Vitrectomy</span> </strong><strong>(Option A)</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Surgery: </strong>For severe cases or complications (e.g., tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> detachment). Removes <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> gel, and clears debris.</p>\n</td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/qwjzFtAQqqsDj4TO7u8u1746627793.mp3", "video": ""}, {"text": "A 25-year-old female presents with floaters and gradual deterioration of vision. On examination, there is anterior vitritis with white snowball-like exudates and mild peripheral periphlebitis. No other relevant history or clinical findings. Which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "CMV Retinitis", "correct": false}, {"label": "B", "text": "Tuberculosis", "correct": false}, {"label": "C", "text": "Intermediate uveitis", "correct": true}, {"label": "D", "text": "Lyme Uveitis", "correct": false}], "correct_answer": "C. Intermediate uveitis", "question_images": [], "explanation_images": ["https://image.prepladder.com/notes/RB2UOY6dT4uLxhsiudaz1743125257.png"], "explanation": "<table cellspacing=\"0\" style=\"border-collapse:collapse; width:615px\">\n<tbody>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Common Features</strong></p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>Less Frequent Features</strong></p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Floaters</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Macular edema</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vision deterioration due to <span class=\"customMeta\" data-dictid=\"1ba6a9cfe11692777181950edd7a6d\">anterior</span> <span class=\"customMeta\" data-dictid=\"636ccb4336169277720289af6a0778\">vitreous</span> opacities</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Papillitis or disc oedema</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Minimal <span class=\"customMeta\" data-dictid=\"0f0067663b16927771818fe253b3b9\">aqueous</span> <span class=\"customMeta\" data-dictid=\"68e7440bd91692777202d8a14c33e0\">flare</span> with occasional <span class=\"customMeta\" data-dictid=\"9f27a2a3421692777190e4154fc8fc\">keratic</span> precipitates</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Retrolenticular cyclitic membranes</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Anterior Vitritis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Vitreous hemorrhage</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p><strong>White snowball-like exudates</strong> near the <span class=\"customMeta\" data-dictid=\"4ddf5d11d71692777194fac8ecc625\">ora</span> serrata</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Tractional <span class=\"customMeta\" data-dictid=\"fb7a2c30e416927771972f7df6f8c0\">retinal</span> <span class=\"customMeta\" data-dictid=\"2b005085881692777186cf95c3ad51\">detachment</span> (rare)</p>\n</td>\n</tr>\n<tr>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\">\n<p>Mild <span class=\"customMeta\" data-dictid=\"255674f3271692777195c172d86daf\">peripheral</span> periphlebitis</p>\n</td>\n<td style=\"border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; vertical-align:top\"> </td>\n</tr>\n</tbody>\n\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/OIVPXOyxdgTSj08IKCgt1746520064.mp3", "video": ""}, {"text": "A 40-year-old patient presents with eye pain, redness, and a constricted pupil. During the examination, fine, grey deposits on the corneal endothelium are noted. Which of the following is the most appropriate next step in investigating and treating this condition?", "options": [{"label": "A", "text": "Perform a chest X-ray and initiate treatment with topical cycloplegics.", "correct": false}, {"label": "B", "text": "Order a serum ACE level and start treatment with non-steroidal voclosporin.", "correct": false}, {"label": "C", "text": "Conduct an HLA typing and begin treatment with topical prednisolone.", "correct": true}, {"label": "D", "text": "Arrange for an OCT scan and administer systemic interferon-alpha.", "correct": false}], "correct_answer": "C. Conduct an HLA typing and begin treatment with topical prednisolone.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/3yaoemBYqi3vhnnWci801746519135.mp3", "video": ""}, {"text": "A 35-year-old patient presents with a 1-week history of worsening eye pain and redness. On examination, a constricted pupil, a hazy anterior chamber, and deposits on the back of the cornea as shown below. Based on these findings, which of the following is the most likely diagnosis?", "options": [{"label": "A", "text": "Herpes Simplex Keratitis", "correct": false}, {"label": "B", "text": "Conjunctivitis", "correct": false}, {"label": "C", "text": "Anterior Uveitis", "correct": true}, {"label": "D", "text": "Acute Angle Closure Glaucoma", "correct": false}], "correct_answer": "C. Anterior Uveitis", "question_images": ["https://image.prepladder.com/notes/c0wgibBql8v4fZAgGyDI1746622040.png"], "explanation_images": ["https://image.prepladder.com/notes/Ytz1E0FiZ4AKnYuBrZRM1743124792.png", "https://image.prepladder.com/notes/OnGGTdkiiWPNoRp9plqz1743124885.png", "https://image.prepladder.com/notes/ivLwuvIMmWSyIJnOjegr1743125017.png"], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/ODfS1zU4R6cLRc496s781746503642.mp3", "video": ""}, {"text": "A 50-year-old patient presents with anterior uveitis. After a detailed evaluation, the ophthalmologist considers various systemic associations and possible masquerades for the condition. Which of the following conditions is a known systemic association with anterior uveitis, but not a masquerade?", "options": [{"label": "A", "text": "Intraocular Foreign Body", "correct": false}, {"label": "B", "text": "Behcet's Disease", "correct": true}, {"label": "C", "text": "Retinoblastoma", "correct": false}, {"label": "D", "text": "Pigment Dispersion Syndrome", "correct": false}], "correct_answer": "B. Behcet's Disease", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/Xg7rKhr0VKZGjsldd4PR1746453534.mp3", "video": ""}, {"text": "Which of the following statements about the classification of uveitis based on the time of inflammatory activity is false?", "options": [{"label": "A", "text": "Acute uveitis is defined as having a duration of less than 3 months and typically has a sudden onset.", "correct": false}, {"label": "B", "text": "Chronic uveitis is classified as lasting more than 6 months without interruption.", "correct": true}, {"label": "C", "text": "Recurrent uveitis involves repeated episodes with periods of inactivity between them.", "correct": false}, {"label": "D", "text": "Remission in uveitis is defined as no inflammatory activity for 3 months or more.", "correct": false}], "correct_answer": "B. Chronic uveitis is classified as lasting more than 6 months without interruption.", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "https://image.prepladder.com/content/a8OB2dR0TS0nF4VscZbO1746453309.mp3", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 32 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">
<div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-xl font-semibold mb-4">Instructions</h2> <h4 class="text-gray-800 text-lg font-semibold mt-6 mb-4">Test Features:</h4> <ul class="space-y-3"> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Multiple choice questions with single correct answers </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Timer-based testing for realistic exam conditions </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mark questions for review functionality </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Comprehensive results and performance analysis </li> <li class="flex items-center gap-3"> <i class="fa-solid fa-circle-check text-green-500"></i> Mobile-optimized interface for learning on-the-go </li> </ul> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="start-test">Start Test</button> </div> <div class="error-message hidden" id="error-message"></div> </div> </section> <!-- Quiz Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="quiz"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <!-- Progress Bar --> <div class="w-full bg-gray-200 rounded-full h-3 mb-4"> <div class="progress-bar h-3 rounded-full" id="progress-bar" style="width: 0%"></div> </div> <!-- Question Header --> <div class="flex flex-col md:flex-row justify-between items-center mb-4"> <h2 class="text-lg font-semibold" id="question-number">Question <span>1</span> of 4</h2> <p class="text-lg font-semibold mt-2 md:mt-0" id="timer">Time Remaining: <span>00:00</span></p> </div> <!-- Question Content --> <div class="mb-6" id="question-content"> <p class="text-gray-800 mb-4" id="question-text"></p> <div class="flex flex-wrap gap-4 mb-4" id="question-images"></div> <div class="space-y-3" id="options"></div> </div> <!-- Navigation Buttons --> <div class="flex flex-col md:flex-row justify-between items-center gap-2 md:gap-4"> <div class="flex gap-2 w-full md:w-auto"> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="previous-btn">Previous</button> <button class="bg-[#2c5281] text-white px-4 py-3 w-full md:w-32 h-14 rounded-lg hover:bg-[#2c5281] transition" id="next-btn">Next</button> </div> <div class="flex items-center gap-2"> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="mark-review"> Review <svg xmlns="http://www.w3.org/2000/svg" class="h-5 w-5" viewBox="0 0 20 20" fill="currentColor"> <path d="M10 2a1 1 0 00-1 1v14l3.293-3.293a1 1 0 011.414 0L17 17V3a1 1 0 00-1-1H10z" /> </svg> </button> <button class="bg-transparent text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-100 transition flex items-center gap-1" id="nav-toggle"> Question 🧭 </button> <button class="bg-green-500 text-white px-6 py-3 w-44 h-14 rounded-lg hover:bg-green-600 transition w-full md:w-auto" id="submit-test">Submit Test</button> </div> </div> </section> <!-- Results Section --> <section class="container mx-auto px-4 md:px-6 pt-4 md:pt-6 pb-1 hidden section-transition" id="results"> <div class="bg-white rounded-lg shadow-md p-4 md:p-6"> <h2 class="text-2xl font-semibold mb-4">Anaesthesia Machine - Results</h2> <div class="grid grid-cols-1 md:grid-cols-2 gap-4 mb-6"> <p><strong>Correct:</strong> <span id="correct-count" class="text-[#000000]">0</span></p> <p><strong>Wrong:</strong> <span id="wrong-count" class="text-[#000000]">0</span></p> <p><strong>Unanswered:</strong> <span id="unanswered-count" class="text-[#000000]-500">0</span></p> <p><strong>Marked for Review:</strong> <span id="marked-count" class="text-[#000000]">0</span></p> </div> <h3 class="text-lg font-semibold mb-4" id="result-question-number">Question <span>1</span> of 4</h3> <div class="space-y-6" id="results-content"></div> <div class="result-nav"> <button aria-label="Previous question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" disabled="" id="prev-result">Previous</button> <button aria-label="Toggle results navigation panel" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="results-nav-toggle">Result 🧭</button> <button aria-label="Next question result" class="result-nav-btn bg-[#2c5281] text-white px-6 py-2 rounded-lg hover:bg-[#2c5281] transition" id="next-result">Next</button> </div> <div class="mt-6 flex space-x-4 button-group md:flex-row flex-col"> <button class="bg-green-500 text-white px-6 py-2 rounded-lg hover:bg-green-600 transition" id="take-again">Take Again</button> </div> </div> </section> <!-- Exit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="exit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Leave Test?</h2> <p class="text-gray-700 mb-4">Your progress will be lost if you leave this page. Are you sure you want to exit?</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="continue-test">No, Continue</button> <button class="bg-red-500 text-white px-4 py-2 rounded-lg hover:bg-red-600 transition" id="exit-test">Yes, Exit</button> </div> </div> </div> <!-- Submit Confirmation Modal --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 hidden" id="submit-modal" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white rounded-lg p-6 max-w-sm w-full"> <h2 class="text-xl font-semibold mb-4">Confirm Submission</h2> <p class="text-gray-700 mb-2">You have attempted <span id="attempted-count">0</span> of 4 questions.</p> <p class="text-gray-700 mb-4"><span id="unattempted-count">0</span> questions are unattempted.</p> <div class="flex justify-end space-x-4"> <button class="bg-gray-300 text-gray-700 px-4 py-2 rounded-lg hover:bg-gray-400 transition" id="cancel-submit">Cancel</button> <button class="text-white px-4 py-2 rounded-lg hover:bg-[#1a365d] transition" style="background-color: #2c5281;" id="confirm-submit">Submit Test</button> </div> </div> </div> <!-- Quiz Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 nav-panel hidden overflow-y-auto" id="nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Questions Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-nav">Close</button> </div> </div> <!-- Results Navigation Panel --> <div class="fixed inset-0 bg-black bg-opacity-50 flex items-start justify-center p-4 z-50 results-nav-panel hidden overflow-y-auto" id="results-nav-panel" style="align-items: flex-start; padding-top: 33vh;"> <div class="bg-white shadow-lg p-4 rounded-lg w-full max-w-2xl max-h-[80vh] overflow-y-auto"> <h2 class="text-lg font-semibold mb-4">Results Navigation</h2> <div class="mb-4"> <select class="w-full p-2 border rounded-lg text-gray-700" id="results-nav-filter"> <option value="all">All Questions</option> <option value="answered">Answered</option> <option value="unanswered">Unanswered</option> <option value="marked">Marked for Review</option> </select> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> </div> <div class="grid grid-cols-5 gap-2 md:gap-3" id="results-nav-grid"></div> <button class="mt-4 bg-gray-500 text-white px-4 py-2 rounded-lg hover:bg-gray-600 transition w-full" id="close-results-nav">Close</button> </div> <!-- JavaScript Logic --> <script> // Enable debug mode for detailed logging const DEBUG_MODE = true; // Log debug messages function debugLog(message) { if (DEBUG_MODE) { console.log(`[DEBUG] ${message}`); } } // Initialize questions with error handling let questions = []; let currentResultQuestion = 0; // State for current question in results try { debugLog("Attempting to parse questions_json"); questions = [{"text": "A patient has sudden loss of vision and there is no fundus glow. There is no history of trauma, what could be the likely cause?", "options": [{"label": "A", "text": "Vitreous hemorrhage", "correct": true}, {"label": "B", "text": "Acute anterior uveitis", "correct": false}, {"label": "C", "text": "Optic neuritis", "correct": false}, {"label": "D", "text": "Acute congestive glaucoma", "correct": false}], "correct_answer": "A. Vitreous hemorrhage", "question_images": [], "explanation_images": [], "explanation": "\n\n<p style='font-size: 10px; color: #808080; font-style: italic;'>@dams_new_robot</p>", "bot": "@dams_new_robot", "audio": "", "video": ""}]; if (!Array.isArray(questions) || questions.length === 0) { throw new Error("Questions data is empty or invalid"); } debugLog(`Successfully parsed ${questions.length} questions`); } catch (e) { console.error("Failed to parse questions_json:", e); document.getElementById('error-message').innerHTML = "Error loading quiz data. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; // Fallback to sample questions for testing questions = [ { text: "What is 2 + 2?", options: [ { label: "A", text: "3", correct: false }, { label: "B", text: "4", correct: true }, { label: "C", text: "5", correct: false }, { label: "D", text: "6", correct: false } ], correct_answer: "B. 4", question_images: [], explanation_images: [], explanation: "<p>2 + 2 = 4</p><p>@dams_new_robot</p>", bot: "@dams_new_robot", audio: "", video: "" } ]; debugLog("Loaded fallback questions"); } // Quiz state let currentQuestion = 0; let answers = new Array(questions.length).fill(null); let markedForReview = new Array(questions.length).fill(false); let timeRemaining = 11 * 60; // Duration in seconds let timerInterval = null; const quizId = `{title.replace(/\s+/g, '_').toLowerCase()}`; // Unique ID for local storage // Load saved progress function loadProgress() { try { debugLog("Loading progress from localStorage"); const saved = localStorage.getItem(`quiz_${quizId}`); if (saved) { const { savedAnswers, savedMarked, savedTime } = JSON.parse(saved); answers = savedAnswers || answers; markedForReview = savedMarked || markedForReview; timeRemaining = savedTime !== undefined ? savedTime : timeRemaining; debugLog("Progress loaded successfully"); } else { debugLog("No saved progress found"); } } catch (e) { console.error("Error loading progress:", e); debugLog("Failed to load progress: " + e.message); } } // Save progress function saveProgress() { try { debugLog("Saving progress to localStorage"); localStorage.setItem(`quiz_${quizId}`, JSON.stringify({ savedAnswers: answers, savedMarked: markedForReview, savedTime: timeRemaining })); debugLog("Progress saved successfully"); } catch (e) { console.error("Error saving progress:", e); debugLog("Failed to save progress: " + e.message); } } // Initialize quiz function initQuiz() { try { debugLog("Initializing quiz"); loadProgress(); const startButton = document.getElementById('start-test'); if (!startButton) { throw new Error("Start test button not found"); } startButton.addEventListener('click', startQuiz); debugLog("Start test button listener attached"); document.getElementById('previous-btn').addEventListener('click', showPreviousQuestion); document.getElementById('next-btn').addEventListener('click', showNextQuestion); document.getElementById('mark-review').addEventListener('click', toggleMarkForReview); document.getElementById('nav-toggle').addEventListener('click', toggleNavPanel); document.getElementById('submit-test').addEventListener('click', showSubmitModal); document.getElementById('continue-test').addEventListener('click', closeExitModal); document.getElementById('exit-test').addEventListener('click', () => { debugLog("Exiting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('cancel-submit').addEventListener('click', closeSubmitModal); document.getElementById('confirm-submit').addEventListener('click', submitTest); document.getElementById('take-again').addEventListener('click', () => { debugLog("Restarting test"); localStorage.removeItem(`quiz_${quizId}`); window.location.reload(); }); document.getElementById('close-nav').addEventListener('click', toggleNavPanel); document.getElementById('nav-filter').addEventListener('change', updateNavPanel); document.getElementById('prev-result').addEventListener('click', showPreviousResult); document.getElementById('next-result').addEventListener('click', showNextResult); document.getElementById('results-nav-toggle').addEventListener('click', toggleResultsNavPanel); document.getElementById('close-results-nav').addEventListener('click', toggleResultsNavPanel); document.getElementById('results-nav-filter').addEventListener('change', updateResultsNavPanel); debugLog("Quiz initialized successfully"); } catch (e) { console.error("Failed to initialize quiz:", e); debugLog("Failed to initialize quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('start-test').disabled = true; } } // Start quiz function startQuiz() { try { debugLog("Starting quiz"); document.getElementById('instructions').classList.add('hidden'); document.getElementById('quiz').classList.remove('hidden'); showQuestion(currentQuestion); startTimer(); updateNavPanel(); debugLog("Quiz started successfully"); } catch (e) { console.error("Error starting quiz:", e); debugLog("Failed to start quiz: " + e.message); document.getElementById('error-message').innerHTML = "Error starting quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); document.getElementById('quiz').classList.add('hidden'); document.getElementById('instructions').classList.remove('hidden'); } } // Show question function showQuestion(index) { try { debugLog(`Showing question ${index + 1}`); currentQuestion = index; const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } document.getElementById('question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('question-text').innerHTML = q.text || "No question text available"; const imagesDiv = document.getElementById('question-images'); imagesDiv.innerHTML = q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg">`).join('') : ''; const optionsDiv = document.getElementById('options'); optionsDiv.innerHTML = q.options && q.options.length > 0 ? q.options.map(opt => ` <button class="option-btn w-full text-left p-3 border rounded-lg ${answers[index] === opt.label ? 'selected' : ''}" onclick="selectOption(${index}, '${opt.label}')" aria-label="Option ${opt.label}: ${opt.text}"> ${opt.label}. ${opt.text} </button> `).join('') : '<p class="text-red-500">No options available</p>'; document.getElementById('previous-btn').disabled = index === 0; document.getElementById('next-btn').disabled = index === questions.length - 1; document.getElementById('mark-review').classList.toggle('marked', markedForReview[index]); updateProgressBar(); saveProgress(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying question:", e); debugLog("Failed to display question: " + e.message); } } // Select option function selectOption(index, label) { try { debugLog(`Selecting option ${label} for question ${index + 1}`); answers[index] = label; const optionsDiv = document.getElementById('options'); const optionButtons = optionsDiv.querySelectorAll('.option-btn'); optionButtons.forEach(btn => { const btnLabel = btn.textContent.trim().split('.')[0]; btn.classList.toggle('selected', btnLabel === label); }); updateNavPanel(); saveProgress(); debugLog(`Option ${label} selected for question ${index + 1}`); } catch (e) { console.error("Error selecting option:", e); debugLog("Failed to select option: " + e.message); } } // Toggle mark for review function toggleMarkForReview() { try { debugLog(`Toggling mark for review on question ${currentQuestion + 1}`); markedForReview[currentQuestion] = !markedForReview[currentQuestion]; document.getElementById('mark-review').classList.toggle('marked', markedForReview[currentQuestion]); updateNavPanel(); saveProgress(); debugLog(`Mark for review toggled for question ${currentQuestion + 1}`); } catch (e) { console.error("Error marking for review:", e); debugLog("Failed to mark for review: " + e.message); } } // Navigate to previous question function showPreviousQuestion() { try { debugLog(`Navigating to previous question from ${currentQuestion + 1}`); if (currentQuestion > 0) { currentQuestion--; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to previous question:", e); debugLog("Failed to navigate to previous question: " + e.message); } } // Navigate to next question function showNextQuestion() { try { debugLog(`Navigating to next question from ${currentQuestion + 1}`); if (currentQuestion < questions.length - 1) { currentQuestion++; showQuestion(currentQuestion); } } catch (e) { console.error("Error navigating to next question:", e); debugLog("Failed to navigate to next question: " + e.message); } } // Handle question navigation click function handleQuestionNavClick(index) { try { debugLog(`Navigating to question ${index + 1} via nav panel`); showQuestion(index); toggleNavPanel(); } catch (e) { console.error("Error handling navigation click:", e); debugLog("Failed to navigate via nav panel: " + e.message); } } // Start timer function startTimer() { try { debugLog("Starting timer"); timerInterval = setInterval(() => { if (timeRemaining <= 0) { debugLog("Timer expired, submitting test"); clearInterval(timerInterval); submitTest(); } else { timeRemaining--; const minutes = Math.floor(timeRemaining / 60); const seconds = timeRemaining % 60; document.getElementById('timer').innerHTML = `Time Remaining: <span>${minutes.toString().padStart(2, '0')}:${seconds.toString().padStart(2, '0')}</span>`; saveProgress(); } }, 1000); debugLog("Timer started successfully"); } catch (e) { console.error("Error starting timer:", e); debugLog("Failed to start timer: " + e.message); } } // Update progress bar function updateProgressBar() { try { debugLog("Updating progress bar"); const progress = ((currentQuestion + 1) / questions.length) * 100; document.getElementById('progress-bar').style.width = `${progress}%`; debugLog("Progress bar updated"); } catch (e) { console.error("Error updating progress bar:", e); debugLog("Failed to update progress bar: " + e.message); } } // Update quiz navigation panel function updateNavPanel() { try { debugLog("Updating quiz navigation panel"); const filter = document.getElementById('nav-filter').value; const navGrid = document.getElementById('nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="question-nav-btn ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleQuestionNavClick(${i})" aria-label="Go to Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Quiz navigation panel updated"); } catch (e) { console.error("Error updating quiz navigation panel:", e); debugLog("Failed to update quiz navigation panel: " + e.message); } } // Update results navigation panel function updateResultsNavPanel() { try { debugLog("Updating results navigation panel"); const filter = document.getElementById('results-nav-filter').value; const navGrid = document.getElementById('results-nav-grid'); navGrid.innerHTML = questions.map((_, i) => { if (filter === 'answered' && !answers[i]) return ''; if (filter === 'unanswered' && answers[i]) return ''; if (filter === 'marked' && !markedForReview[i]) return ''; return ` <button class="result-nav-btn-grid ${answers[i] ? 'answered' : 'unanswered'} ${markedForReview[i] ? 'marked-nav' : ''}" onclick="handleResultNavClick(${i})" aria-label="Go to Result for Question ${i + 1}"> ${i + 1} </button> `; }).join(''); debugLog("Results navigation panel updated"); } catch (e) { console.error("Error updating results navigation panel:", e); debugLog("Failed to update results navigation panel: " + e.message); } } // Toggle quiz navigation panel function toggleNavPanel() { try { debugLog("Toggling quiz navigation panel"); const navPanel = document.getElementById('nav-panel'); navPanel.classList.toggle('hidden'); debugLog("Quiz navigation panel toggled"); } catch (e) { console.error("Error toggling quiz navigation panel:", e); debugLog("Failed to toggle quiz navigation panel: " + e.message); } } // Toggle results navigation panel function toggleResultsNavPanel() { try { debugLog("Toggling results navigation panel"); const resultsNavPanel = document.getElementById('results-nav-panel'); resultsNavPanel.classList.toggle('hidden'); if (!resultsNavPanel.classList.contains('hidden')) { updateResultsNavPanel(); } debugLog("Results navigation panel toggled"); } catch (e) { console.error("Error toggling results navigation panel:", e); debugLog("Failed to toggle results navigation panel: " + e.message); } } // Handle result navigation click function handleResultNavClick(index) { try { debugLog(`Navigating to result for question ${index + 1} via nav panel`); showResults(index); toggleResultsNavPanel(); } catch (e) { console.error("Error handling result navigation click:", e); debugLog("Failed to navigate to result: " + e.message); } } // Show submit modal function showSubmitModal() { try { debugLog("Showing submit modal"); const attempted = answers.filter(a => a !== null).length; document.getElementById('attempted-count').textContent = attempted; document.getElementById('unattempted-count').textContent = questions.length - attempted; document.getElementById('submit-modal').classList.remove('hidden'); debugLog("Submit modal displayed"); } catch (e) { console.error("Error showing submit modal:", e); debugLog("Failed to show submit modal: " + e.message); } } // Close submit modal function closeSubmitModal() { try { debugLog("Closing submit modal"); document.getElementById('submit-modal').classList.add('hidden'); debugLog("Submit modal closed"); } catch (e) { console.error("Error closing submit modal:", e); debugLog("Failed to close submit modal: " + e.message); } } // Close exit modal function closeExitModal() { try { debugLog("Closing exit modal"); document.getElementById('exit-modal').classList.add('hidden'); debugLog("Exit modal closed"); } catch (e) { console.error("Error closing exit modal:", e); debugLog("Failed to close exit modal: " + e.message); } } // Submit test function submitTest() { try { debugLog("Submitting test"); clearInterval(timerInterval); document.getElementById('quiz').classList.add('hidden'); document.getElementById('submit-modal').classList.add('hidden'); document.getElementById('results').classList.remove('hidden'); showResults(0); // Start with first question // Trigger confetti animation confetti({ particleCount: 100, spread: 70, origin: { y: 0.6 } }); localStorage.removeItem(`quiz_${quizId}`); debugLog("Test submitted successfully"); } catch (e) { console.error("Error submitting test:", e); debugLog("Failed to submit test: " + e.message); } } // Show result for a single question function showResults(index) { try { debugLog(`Showing result for question ${index + 1}`); currentResultQuestion = index; let correct = 0, wrong = 0, unanswered = 0, marked = 0; answers.forEach((answer, i) => { const isCorrect = answer && questions[i].options.find(opt => opt.label === answer)?.correct; if (answer === null) unanswered++; else if (isCorrect) correct++; else wrong++; if (markedForReview[i]) marked++; }); const q = questions[index]; if (!q) { throw new Error(`Question ${index} is undefined`); } const userAnswer = answers[index]; const isCorrect = userAnswer && q.options.find(opt => opt.label === userAnswer)?.correct; const resultsContent = document.getElementById('results-content'); resultsContent.innerHTML = ` <div class="border p-4 rounded-lg ${isCorrect ? 'bg-green-50' : userAnswer ? 'bg-red-50' : 'bg-gray-50'}"> <p class="font-semibold">Question ${index + 1}: ${q.text || 'No question text'}</p> ${q.question_images && q.question_images.length > 0 ? q.question_images.map(url => `<img src="${url}" alt="Question Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} <p><strong>Your Answer:</strong> ${userAnswer ? `${userAnswer}. ${q.options.find(opt => opt.label === userAnswer)?.text || 'Invalid option'}` : 'Unanswered'}</p> <p><strong>Correct Answer:</strong> ${q.correct_answer || 'Unknown'}</p> <div class="mt-2">${q.explanation || 'No explanation available'}</div> ${q.explanation_images && q.explanation_images.length > 0 ? q.explanation_images.map(url => `<img src="${url}" alt="Explanation Image" class="max-w-full h-auto rounded-lg my-2">`).join('') : ''} ${q.video ? ` <button class="play-video bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadVideo(this, '${q.video}', 'video-${index}')" aria-label="Play explanation video for Question ${index + 1}"> Play Video Explanation </button> <div id="video-${index}" class="video-container mt-2"></div> ` : '<p class="text-gray-500 mt-2">No video available</p>'} ${q.audio ? ` <button class="play-audio bg-blue-500 text-white px-4 py-2 rounded-lg mt-2" onclick="loadAudio(this, '${q.audio}', 'audio-${index}')" aria-label="Play audio explanation for Question ${index + 1}"> Play Audio Explanation </button> <div id="audio-${index}" class="audio-container mt-2"></div> ` : ''} </div> `; document.getElementById('correct-count').textContent = correct; document.getElementById('wrong-count').textContent = wrong; document.getElementById('unanswered-count').textContent = unanswered; document.getElementById('marked-count').textContent = marked; document.getElementById('result-question-number').innerHTML = `Question <span>${index + 1}</span> of ${questions.length}`; document.getElementById('prev-result').disabled = index === 0; document.getElementById('next-result').disabled = index === questions.length - 1; updateResultsNavPanel(); window.scrollTo({ top: 0, behavior: 'smooth' }); debugLog(`Result for question ${index + 1} displayed successfully`); } catch (e) { console.error("Error displaying result:", e); debugLog("Failed to display result: " + e.message); } } // Navigate to previous result function showPreviousResult() { try { debugLog(`Navigating to previous result from question ${currentResultQuestion + 1}`); if (currentResultQuestion > 0) { showResults(currentResultQuestion - 1); } } catch (e) { console.error("Error navigating to previous result:", e); debugLog("Failed to navigate to previous result: " + e.message); } } // Navigate to next result function showNextResult() { try { debugLog(`Navigating to next result from question ${currentResultQuestion + 1}`); if (currentResultQuestion < questions.length - 1) { showResults(currentResultQuestion + 1); } } catch (e) { console.error("Error navigating to next result:", e); debugLog("Failed to navigate to next result: " + e.message); } } // Lazy-load video function loadVideo(button, videoUrl, containerId) { try { debugLog(`Loading video for ${containerId}: ${videoUrl}`); if (!videoUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No video available</p>`; button.remove(); debugLog("No video URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <div class="video-loading"></div> <video controls class="w-full max-w-[600px] rounded-lg" preload="metadata" aria-label="Video explanation"> <source src="${videoUrl}" type="${videoUrl.endsWith('.m3u8') ? 'application/x-mpegURL' : 'video/mp4'}"> Your browser does not support the video tag. </video> `; container.classList.add('active'); button.remove(); // Initialize HLS.js for .m3u8 videos const video = container.querySelector('video'); if (videoUrl.endsWith('.m3u8') && Hls.isSupported()) { const hls = new Hls(); hls.loadSource(videoUrl); hls.attachMedia(video); hls.on(Hls.Events.ERROR, (event, data) => { console.error("HLS.js error:", data); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("HLS.js error: " + JSON.stringify(data)); }); } else if (videoUrl.endsWith('.m3u8') && video.canPlayType('application/vnd.apple.mpegurl')) { video.src = videoUrl; } // Handle video load errors video.onerror = () => { console.error("Video load error for URL:", videoUrl); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; debugLog("Video load error for URL: " + videoUrl); }; // Remove loading spinner when video is ready video.onloadedmetadata = () => { container.querySelector('.video-loading').remove(); debugLog("Video loaded successfully"); }; } catch (e) { console.error("Error loading video:", e); debugLog("Failed to load video: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading video. <a href="${videoUrl}" target="_blank" aria-label="Open video in new tab">Open video</a></p>`; } } // Lazy-load audio function loadAudio(button, audioUrl, containerId) { try { debugLog(`Loading audio for ${containerId}: ${audioUrl}`); if (!audioUrl) { const container = document.getElementById(containerId); container.innerHTML = `<p class="text-gray-500">No audio available</p>`; button.remove(); debugLog("No audio URL provided"); return; } const container = document.getElementById(containerId); container.innerHTML = ` <audio controls class="w-full max-w-[600px]" preload="metadata" aria-label="Audio explanation"> <source src="${audioUrl}" type="audio/mpeg"> Your browser does not support the audio tag. </audio> `; container.classList.add('active'); button.remove(); // Handle audio load errors const audio = container.querySelector('audio'); audio.onerror = () => { console.error("Audio load error for URL:", audioUrl); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; debugLog("Audio load error for URL: " + audioUrl); }; debugLog("Audio loaded successfully"); } catch (e) { console.error("Error loading audio:", e); debugLog("Failed to load audio: " + e.message); const container = document.getElementById(containerId); container.innerHTML = `<p class="text-red-500">Error loading audio. <a href="${audioUrl}" target="_blank" aria-label="Open audio in new tab">Open audio</a></p>`; } } // Toggle dark mode function toggleTheme() { try { debugLog("Toggling theme"); document.documentElement.classList.toggle('dark'); localStorage.setItem('theme', document.documentElement.classList.contains('dark') ? 'dark' : 'light'); debugLog("Theme toggled successfully"); } catch (e) { console.error("Error toggling theme:", e); debugLog("Failed to toggle theme: " + e.message); } } // Load theme preference function loadTheme() { try { debugLog("Loading theme preference"); const theme = localStorage.getItem('theme'); if (theme === 'dark') { document.documentElement.classList.add('dark'); } debugLog("Theme loaded successfully"); } catch (e) { console.error("Error loading theme:", e); debugLog("Failed to load theme: " + e.message); } } // Initialize on DOM content loaded window.addEventListener('DOMContentLoaded', () => { try { debugLog("DOM content loaded, initializing quiz"); loadTheme(); initQuiz(); } catch (e) { console.error("Error during DOMContentLoaded:", e); debugLog("Failed to initialize on DOMContentLoaded: " + e.message); document.getElementById('error-message').innerHTML = "Error initializing quiz. Please check the console for details or contact support."; document.getElementById('error-message').classList.remove('hidden'); } }); </script> </body> </html>" frameborder="0" width="100%" height="2000px">